摘要
目的探讨单核细胞/高密度脂蛋白比值(MHR)、单核细胞/淋巴细胞比值(MLR)与非ST段抬高型心肌梗死(NSTEMI)及冠状动脉病变严重程度的关系。方法选取2014年6月—2018年1月蓬莱市人民医院收治的NSTEMI患者306例作为观察组,同期经冠状动脉造影检查证实为非冠心病患者168例作为对照组。比较两组患者一般资料、实验室检查指标;MHR、MLR与NSTEMI的关系分析采用多因素Logistic回归分析;绘制受试者工作特征(ROC)曲线以评价MHR、MLR对NSTEMI的诊断价值;MHR、MLR与NSTEMI患者SYNTAX评分的相关性分析采用Pearson相关分析。结果 (1)两组患者年龄、性别、体质指数(BMI)、饮酒史、三酰甘油(TG)、总胆固醇(TC)比较,差异无统计学意义(P>0.05);观察组患者中有冠心病家族史、高血压病史、糖尿病病史、吸烟史者所占比例及白细胞计数、中性粒细胞计数、单核细胞计数、低密度脂蛋白(LDL)、MHR、MLR高于对照组,淋巴细胞计数、高密度脂蛋白(HDL)低于对照组(P<0.05)。(2)多因素Logistic回归分析结果显示,MHR[OR=2.787,95%CI(1.181,6.576)]、MLR[OR=2.540,95%CI(1.538,4.194)]是NSTEMI的独立影响因素(P<0.05)。(3)绘制ROC曲线发现,MHR诊断NSTEMI的曲线下面积(AUC)为0.698[95%CI(0.651,0.746)],灵敏度为66.63%,特异度为74.62%;MLR诊断NSTEMI的AUC为0.682[95%CI(0.632,0.733)],灵敏度为69.97%,特异度为67.93%;MHR联合MLR诊断NSTEMI的AUC为0.746[95%CI(0.701,0.791)],灵敏度为75.71%,特异度为80.79%。MHR联合MLR诊断NSTEMI的AUC高于MHR、MLR(P<0.05)。(4)Pearson相关分析结果显示,MHR(r=0.645)、MLR(r=0.612)与NSTEMI患者SYNTAX评分呈正相关(P<0.05)。结论 MHR、MLR是NSTEMI的独立影响因素,与冠状动脉病变严重程度呈正相关,可作为辅助诊断NSTEMI的指标。
Objective To investigate the relationship between monocyte/high-density lipoprotein ratio(MHR),monocyte/lymphocyte ratio(MLR)and non ST-segment elevation myocardial infarction(NSTEMI),severity of coronary artery lesion.Methods A total of306patients with NSTEMI were selected as observation group in the People's Hospital of Penglai from June2014to January2018,meanwhile a total of168non coronary heart disease patients confirmed by coronary angiography were selected as control group.General information and laboratory examination results were compared between the two groups;multivariate Logistic regression analysis was used to analyze the relationship between MHR,MLR and NSTEMI;ROC curve was drawn to evaluate the diagnostic value of MHR and MLR in diagnosing NSTEMI;Pearson correlation was used to analyzed the correlations of MHR and MLR with SYNTAX score in patients with NSTEMI.Results(1)No statistically significant differences of age,gender,BMI,drinking history,TG or TC was found between the two groups(P>0.05);proportion of patients with family history of coronary heart disease,hypertension history,diabetes history and smoking history,WBC,neutrophil count,monocyte count,LDL,MHR and MLR in observation group were statistically significantly higher than those in control group,while lymphocyte count and HDL in observation group were statistically significantly lower than those in control group(P<0.05).(2)Multivariate Logistic regression analysis results showed that,MHR〔OR=2.787,95%CI(1.181,6.576)〕and MLR〔OR=2.540,95%CI(1.538,4.194)〕were independent influencing factors of NSTEMI(P<0.05).(3)ROC curve showed that,AUC of MHR in diagnosing NSTEMI was0.698〔95%CI(0.651,0.746)〕,the sensitivity was66.63%,the specificity was74.62%;AUC of MLR in diagnosing NSTEMI was0.682〔95%CI(0.632,0.733)〕,the sensitivity was69.97%,the specificity was67.93%;AUC of MHR combined with MLR in diagnosing NSTEMI was0.746〔95%CI(0.701,0.791)〕,the sensitivity was75.71%,the specificity was80.79%,meanwhile AUC of MHR combined with MLR diagnosing NSTEMI was statistically significantly higher than that of MHR and MLR,respectively(P<0.05).(4)Pearson correlation analysis results showed that,MHR(r=0.645)and MLR(r=0.612)was positively correlated with SYNTAX score in patients with NSTEMI(P<0.05).Conclusion MHR and MLR are independent influencing factors of NSTEMI,and they are positively correlated with severity of coronary artery lesion,which may be the index for auxiliary diagnosis of NSTEMI.
作者
王熙智
秦海燕
WANG Xi-zhi;QIN Hai-yan(The People's Hospital of Penglai,Penglai 265600,China)
出处
《实用心脑肺血管病杂志》
2018年第10期18-23,共6页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
心肌梗死
单核细胞
淋巴细胞
高密度脂蛋白
冠状动脉病变
Myocardial infarction
Monocyte
Lymphocyte
High-density lipoprotein
Coronary artery lesion
