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| UHR评估高龄ASCVD患者不良事件发生的应用价值 |
| Value of UHR in evaluating adverse events in elderly patients with ASCVD |
| 投稿时间：2025-06-21 |
| DOI：10.3969/j.issn.1000-0399.2026.03.009 |
| 中文关键词: 尿酸与高密度脂蛋白胆固醇比值 高龄 动脉粥样硬化性心血管疾病 危险因素 |
| 英文关键词: Uric acid to high-density lipoprotein cholesterol ratio Elderly Atherosclerotic cardio-vascular disease Risk factors |
| 基金项目:青岛市医疗卫生优秀人才培养项目资助(编号:青卫科教字[2024]3号); 青岛市卫健委项目(编号:2025-WJKY225) |
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| 中文摘要: |
| 目的 评估尿酸（UA）与高密度脂蛋白胆固醇（HDL-C）比值（UHR）在预测高龄动脉粥样硬化性心血管疾病（ASCVD）患者不良事件发生的应用价值。方法 选取2022年1月至2024年12月于海军第九七一医院保健一科住院且年龄≥80岁的ASCVD患者126例为研究对象，根据有无心脑血管不良事件发生，将患者分为病例组（n=44）和对照组（n=82）。收集两组患者的临床资料、实验室检验结果，计算UHR。采用多因素logistic回归分析不良事件发生的独立危险因素，受试者工作特征（ROC）曲线评估独立危险因素对不良事件发生的预测能力。结果 病例组的淋巴细胞、单核细胞、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、UHR高于对照组，而清蛋白低于对照组，差异均有统计学意义（P均<0.05）。多因素logistic回归分析结果显示，UHR（OR=1.005,95%CI:1.001～1.009,P=0.013）和单核细胞（OR=13.051,95%CI:1.759～96.808,P=0.012）是高龄ASCVD患者不良事件发生的独立危险因素；ROC曲线分析结果显示，UHR的曲线下面积（95%CI）为0.739（0.651～0.828），灵敏度为73.0%，特异度为72.0%，截断值为328.50×10-3；单核细胞的曲线下面积（95%CI）为0.679（0.575～0.783），灵敏度为47.7%，特异度为92.7%，截断值为0.605×10～9/L;UHR联合单核细胞的曲线下面积（95%CI）为0.758（0.670～0.847），灵敏度为77.0%，特异度为31.0%，截断值为3.85。结论 UHR可作为评估高龄ASCVD患者不良事件发生的有效指标；单核细胞预测效能灵敏度低（47.7%）、UHR联合单核细胞预测效能特异度低（31.0%），不推荐作为评估指标。 |
| 英文摘要: |
| Objective To evaluate the value of the uric acid to high-density lipoprotein cholesterol ratio in evaluating adverse events in elderly patients with atherosclerotic cardiovascular disease. Methods From January 1, 2022 to December 31, 2024, 126 patients aged≥80 years with atherosclerotic cardiovascular disease were selected from the Department of Health Care Division I of the No.971 Hospital of the Navy and divided into a case group(n=44) and a control group(n=82) based on the occurrence of cardiovascular and cere-brovascular adverse events. Baseline data and laboratory test results for two groups of patients were collected, and the uric acid to high-density lipoprotein cholesterol ratio was calculated. Multi-variate logistic regression was used to analyze independent risk factors of adverse events; receiver operating characteristic curve was used to evaluate the predictive ability of independent risk factors for adverse events. Results Lymphocytes, monocytes, triglyceride, low-density lipoprotein cholesterol and UHR in the case group were higher than those in the control group, while albumin was lower than that in the control group, and the differences were statistically significant(all P< 0.05). Multivariate logistic regression showed that the uric acid to high-density lipoprotein cholesterol ratio(OR=1.005, 95%CI: 1.001～1.009, P=0.013) and monocytes(OR=13.051, 95%CI: 1.759～96.808, P=0.012) were the independent risk factors for adverse events in elderly patients with atherosclerotic cardiovascular disease. Receiver operating characteristic curve analysis revealed that the area under the curve(95% CI) for the uric acid to high-density lipoprotein cholesterol ratio was 0.739(0.651～0.828), with a sensitivity of 73.0%, specificity of 72%, and a cut-off value of 328.50. The area under the curve(95% CI) for monocytes was 0.679(0.575～0.783), with a sensitivity of 47.7%, specificity of 92.7%, and a cut-off value of 0.605. The area under the curve(95% CI) for the uric acid to high-density lipoprotein cholesterol ratio combined with monocytes was 0.758(0.670～0.847), with a sensitivity of 77.0%, specificity of 31.0%, and a cut-off value of 3.85. Conclusion The uric acid to high-density lipoprotein cholesterol ratio can be used as an effective indicator to evaluate the occurrence of adverse events in in elderly patients with atherosclerotic cardiovascular disease. The sensitivity of monocyte predictive efficacy is low(47.7%), and the specificity of the uric acid to high-density lipoprotein cholesterol ratio combined with monocyte predictive efficacy is low(31.0%), which is not recommended as an evaluation index. |
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