基于倾向评分匹配法分析甘油三酯葡萄糖指数与冠状动脉支架植入术后非靶病变进展的相关性-东南大学学报医学版

基于倾向评分匹配法分析甘油三酯葡萄糖指数与冠状动脉支架植入术后非靶病变进展的相关性

单位：南京医科大学附属泰州人民医院心血管内科, 江苏泰州 225300

关键词：倾向评分匹配法冠状动脉粥样硬化性心脏病冠状动脉支架植入术甘油三酯葡萄糖指数非靶病变进展

分类号：R541.4;R654.2

出版年·卷·期（页码）：2024·43·第六期（860-867）

摘要：

目的:探讨甘油三酯葡萄糖(TyG)指数与冠状动脉支架植入术后非靶病变(NTL)进展的关系。方法:选择2019年1月至2022年12月期间在南京医科大学附属泰州人民医院进行冠状动脉造影(CAG)及支架植入术,并在术后9~12个月内再次入院复查CAG的患者679例。根据两次住院的定量CAG结果评估NTL进展情况,将患者分为NTL进展组和无进展组(对照组)。采用倾向性评分匹配法(PSM)1∶1构建匹配后的数据集,分析TyG指数与NTL进展之间的关联。采用受试者工作特征(ROC)曲线评价TyG指数对NTL进展的预测价值。结果:采用PSM后,与对照组相比,NTL进展组的TyG指数及其总体四分位分布差异有统计学意义(均P<0.05)。Logistic回归分析结果显示,TyG指数是NTL进展的独立危险因素。与TyG指数最低四分位组相比,最高四分位组的NTL进展风险增倍(OR=2.05,95%CI:1.03~4.45,P=0.038)。限制性立方样条曲线提示,随着TyG指数的增加,NTL进展的风险逐渐增加,存在剂量-反应关系。TyG指数预测NTL进展的ROC曲线下面积为0.607(95%CI:0.554~0.660)。结论:TyG指数是冠状动脉支架植入术后NTL进展的独立危险因素,并对NTL进展具有一定的预测价值。

Objective: To investigate the relationship between the triglyceride-glucose(TyG) index and the progression of non-target lesions(NTL) after coronary stenting. Methods: A total of 679 patients who underwent coronary angiography(CAG) and stenting at the Affiliated Taizhou People's Hospital of Nanjing Medical University from January 2019 to December 2022 were selected. These patients were readmitted for follow-up CAG 9-12 months post-procedure. The presence of NTL progression was assessed based on quantitative CAG results from the two hospitalizations. Patients were divided into an NTL progression group and a non-progression group(control group). A propensity score matching(PSM) method with a 1∶1 ratio was used to construct a matched dataset to analyze the association between TyG index and NTL progression. The predictive value of TyG index for NTL progression was evaluated using receiver operating characteristic(ROC) curves. Results: After PSM, significant differences in TyG index and TyG quartile distributions were observed between the NTL progression group and the control group(both P<0.05). Logistic regression analysis revealed that TyG index was an independent risk factor for NTL progression. The risk of NTL progression was doubled in the highest TyG quartile compared to the lowest TyG index quartile(OR=2.05, 95%CI: 1.03-4.45, P=0.038). Restricted cubic spline curve showed, as TyG index increased, the risk of NTL progression also increased, showing a dose-response relationship. The area under the ROC curve for TyG index predicting NTL progression was 0.607(95%CI: 0.554-0.660). Conclusion: TyG index is an independent risk factor for NTL progression after coronary stenting and has predictive value for NTL progression.

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