冠心病患者血尿素氮与血清白蛋白比值与颈动脉斑块的相关性研究
ssociation between Blood Urea Nitrogen to Serum Albumin Ratio and Carotid Plaque in Patients with Coronary Heart Disease
背景 ?血尿素氮（BUN）与血清白蛋白（ALB）比值（BAR）是一种新兴的生物标志物，近年来被认为与多种心肺系统疾病的不良结局相关，但冠心病（CHD）患者的BAR与颈动脉斑块之间的关系目前尚不明确。目的 ?探讨CHD患者BAR与颈动脉斑块之间的相关性。方法 ?回顾性选取2014年1月—2019年9月天津市6家医院住院的CHD患者入院数据。BAR通过BUN/ALB计算。采用Logistic回归分析，评估CHD患者BAR与颈动脉斑块发生风险、斑块数量和斑块性质之间的相关性，并在校正混杂因素后行进一步分析。绘制BAR诊断颈动脉斑块发生风险的受试者工作特征（ROC）曲线，计算ROC曲线下面积（AUC）。结果 ?共纳入10808例CHD患者数据。其中8158例患有颈动脉斑块，颈动脉斑块患病率为75.5%。将10808例CHD患者数据按BAR的四分位数（Q1，Q2，Q3，Q4）分为4组。Q1组BAR≤-0.3954，-0.3954<Q2组BAR≤-0.1587，-0.15870.1324。与Q1组相比，经过多变量调整后，Q4组的BAR与颈动脉斑块形成的相关性最强（OR=1.512，95%CI=1.273~1.795，P<0.001）。CHD患者BAR诊断颈动脉斑块发生风险的AUC为0.612（95%CI=0.600~0.624）。女性群体中BAR水平与斑块之间有较强的相关性（OR=1.583，95%CI=1.260~1.989，P<0.001），老年群体中BAR与斑块之间有较强的相关性（OR=1.810，95%CI=1.459~2.246，P<0.001）。且BAR与颈动脉斑块的相关性不受高血压、高脂血症、糖尿病等疾病的影响。结论 ?高水平的BAR与颈动脉斑块形成相关，且在女性、中老年人群中更显著。BAR升高可能有助于早期识别CHD患者颈动脉斑块的形成，从而避免主要不良心血管事件的发生。
Background ?The ratio of blood urea nitrogenBUNto serum albumin ALBBARis an emerging biomarker that has been recently recognized to associate with adverse outcomes in a variety of cardiorespiratory disorders. Howeverthe relationship between BAR and carotid plaque in patients with coronary heart diseaseCHDis currently unclear. Objective ?To investigate the correlation between BAR and carotid plaque in CHD patients. Methods ?Admission medical data of CHD patients hospitalized in six hospitals in Tianjin from January 2014 to September 2019 were retrospectively analyzed. BAR was calculated by dividing BUN by ALB. Logistic regression analysis was used to evaluate the correlation of BAR with the occurrencenumber and characteristics of carotid plaque in CHD patients before and after adjusting for confounding factors. Drewa receiver operating characteristicROCcurve for diagnosing the risk of carotid plaque occurrence using BARand calculate the area under the ROC curveAUC. Results ?A total of 10 808 cases of CHD were included. Among them8 158 cases suffered from carotid plaque with a prevalence of 75.5%. The data of 10 808 CHD cases were divided into four groups by quartiles of BARQ1Q2Q3Q4for baseline analysis: Q1 -0.395 4-0.395 4< Q2 -0.158 7-0.158 7 0.132 4. Compared with Q1the correlation between BAR and carotid plaque formation was more significant in Q4 after multivariate adjustmentOR=1.51295%CI=1.273-1.795P<0.001. The AUC for diagnosing the risk of carotid plaque in CHD patients with BAR is 0.612 95%CI=0.600~0.624. The correlation between BAR and plaque was more significant in the female population.OR=1.58395%CI=1.260-1.989P<0.001the correlation between BAR and plaque was more significant in the older age groupOR=1.81095%CI=1.459-2.246P<0.001. The significant correlation between BAR and carotid plaque was not affected by diseases such as hypertensionhyperlipidemia and diabetes. Conclusion ?High-level BAR is associated with carotid plaque formation, and which is more significant in women and middle-aged and elderly people. High level BAR is helpful in an early identification of carotid plaque formation in CHD patientsthus avoiding the occurrence of major adverse cardiovascular eventsMACEs.
绳菁煜、刘凡凡、田霖、高杉、马梅、刘凤敏、刘雨桐、于春泉
临床医学内科学
冠心病血尿素氮血清白蛋白颈动脉斑块影响因素分析天津市
绳菁煜,刘凡凡,田霖,高杉,马梅,刘凤敏,刘雨桐,于春泉.冠心病患者血尿素氮与血清白蛋白比值与颈动脉斑块的相关性研究[EB/OL].(2025-02-26)[2025-08-20].https://chinaxiv.org/abs/202502.00199.点此复制
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