| Objectives: 1.To study the changes of NHDL-C/HDL-C and Apo B/Apo A1 ratio in serum of patients with coronary heart disease and non-coronary heart disease patients based on propensity score matching.2.To explore the relationship between the blood lipid ratio and the severity of coronary artery stenosis in patients with coronary heart disease.3.To evaluate the diagnostic value of blood lipid ratio for coronary heart disease so that it can provide evidence for early diagnosis and intervention of coronary heart disease.Methods: A total of 1001 patients who were diagnosed and treated in the hospital from July 2019 to December 2020 were selected,and the samples were divided into coronary heart disease group(n=568)and non-coronary heart disease group(n=433).After analyzing the clinical data of the two groups,the samples of the coronary heart disease group(n=253)and the non-coronary heart disease group(n=253)were obtained by propensity score matching.The Gensini score is used to evaluate the degree of coronary artery disease and as a basis for grouping.According to the score,the coronary heart disease group is divided into mild coronary artery stenosis group,moderate coronary artery stenosis group and severe coronary artery stenosis group.The patients of three groups were analyzed.Based on clinical data,a multiple linear regression was established to screen the risk factors for the severity of coronary artery lesions.The receiver operating characteristic curve and the area under the curve was used to analyze the diagnostic value of NHDL-C/HDL-C and Apo B/Apo A1 for coronary heart disease.Results: 1.Before propensity score matching,there were significant differences in general information,blood lipid indexes and other laboratory test indexes between the coronary heart disease group and the non-coronary heart disease group(P<0.05).After propensity score matching,the clinical data between the coronary heart disease group and the non-coronary heart disease group were compared,and it was found that the differences in blood lipid indexes were statistically significant(P<0.05).However,there was no significant difference between the general data and other laboratory parameters(P>0.05).Compared with the non-CHD group,the CHD group had higher levels of NHDL-C/HDL-C and Apo B/Apo A1 ratio(P<0.05).2.Comparing the ratios of NHDL-C/HDL-C and Apo B/Apo A1 in mild,moderate and severe coronary artery stenosis groups,it was found that there were significant differences among the three groups(P<0.05).3.Spearman correlation analysis showed that NHDL-C/HDL-C,Apo B/Apo A1,WBC,LDL-C,Apo B and Apo A1 levels were correlated with Gensini score(r=0.18,r=0.24,r=0.23,r=0.15,r=0.17,r=-0.15;P<0.05).4.The collinearity diagnosis of the factors in the correlation analysis found that Apo B/Apo A1 had no obvious collinearity with WBC,NHDL-C/HDL-C,and Apo A1(VIF<5).Therefore,the above indicators were included in the multiple linear regression analysis and found,Apo B/Apo A1 and WBC levels were positively correlated with the severity of coronary artery stenosis(β =0.315,P<0.05;β =0.168,P<0.05),and Apo B/Apo A1 had the greatest correlation.5.The ROC curve showed that the area under the curve of the ratio of NHDL-C/HDL-C and Apo B/Apo Al for the diagnosis of coronary heart disease was 0.715 and 0.758,respectively.Delong test found that the area under the curve of Apo B/Apo Al was larger than that of NHDL-C/HDL-C(P< 0.05).Conclusion: NHDL-C/HDL-C and Apo B/Apo A1 have good value in evaluating the severity of coronary artery stenosis.However,Apo B/Apo A1 has stronger correlation with the severity of coronary artery disease and better diagnostic value than NHDL-C/HDL-C.Apo B/Apo A1 can be preferentially used as an index for evaluating the severity of coronary artery stenosis and diagnosing coronary heart disease in clinical. |
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