摘要
目的本研究旨在探讨新型炎性指标系统免疫炎性指数(SII)、中性粒细胞与高密度脂蛋白胆固醇比值(NHR)对冠状动脉心脏病(CAD)的诊断预测价值。方法纳入2018年1月~2019年11月于承德医学院附属医院住院,符合纳入标准的患者472例为研究对象,根据冠状动脉CT血管造影(CCTA)或冠脉造影(CAG)结果,将所有研究对象分为稳定型心绞痛(SAP)组(n=159)、急性冠脉综合征(ACS)组(n=159)和非CAD组(n=154)。收集所有患者的临床资料,计算SII、NHR。用受试者工作特征曲线(ROC)确定各炎性指标的最佳诊断界值。建立多因素二元Logistic回归模型分析CAD的危险因素。分析炎性指标与冠脉病变严重程度的相关性。结果SAP组NHR、单核细胞与高密度脂蛋白胆固醇比值(MHR)、中性粒细胞与淋巴细胞比值(NLR)、SII的水平均较非CAD组高(P均<0.05)。NHR、NLR、SII和MHR的受试者工作特征曲线下面积(AUC)分别为0.691、0.638、0.630和0.570(P均<0.05)。ACS组NHR、NLR和SII中位数均较非CAD组高,NHR、NLR和SII的AUC分别为0.597、0.610和0.621(P均<0.05)。NHR、NLR、SII与Gensini评分均呈正相关(P均<0.05)。结论SII、NHR升高均为CAD独立危险因素,有望成为CAD诊断的新型标志物。
Objective To explore the diagnostic and prognostic value of the novel inflammatory markers systemic immune-inflammation index(SII)and neutrophil to high-density lipoprotein cholesterol ratio(NHR)on coronary artery disease(CAD).Methods A total of 472 inpatients were enrolled from January 2018 to November 2019 in the Affiliated Hospital of Chengde Medical University.All of them were divided into the SAP group(n=159),the ACS group(n=159),and the non-CAD group(n=154),according to coronary computed tomographic angiography(CCTA)or coronary angiography(CAG)results.The clinical and laboratory data of all the subjects were collected by the postgraduates.Receiver operating characteristic curve(ROC)analysis and Logistic regression analysis was conducted to assess the optimal cutoff and value of SII and NHR for predicting CAD.The correlation between inflammatory markers and the severity of coronary artery disease was analyzed.Results NHR,monocyte to high-density lipoprotein cholesterol ratio(MHR),neutrophil to lymphocyte ratio(NLR),and SII levels in the SAP group were significantly higher than those in the non-CAD group(all P<0.05).The area under the receiver operating characteristic curve(AUC)of the NHR,NLR,SII,and MHR was 0.691,0.638,0.630,0.570,respectively(all P<0.05).NHR,NLR,SII levels in the ACS group were significantly higher than those in the non-CAD group(all P<0.05).The area under the receiver operating characteristic curve(AUC)of the NHR,NLR,SII was 0.597,0.610,0.621,respectively(all P<0.05).NHR,NLR,SII levels were all positively correlated with Gensini scores(all P<0.05).Conclusion Increase in SII and NHR values are all independent risk factors for CAD,which is expected to become novel inflammatory markers for the diagnosis of CAD.
作者
范文俊
刘静怡
史菲
张爱文
司月乔
高秀鑫
孙王乐贤
Fan Wenjun;Liu Jingyi;Shi Fei(Chengde Cardiovascular Institute&Division of Cardiology,The Affiliated Hospital of Chengde Medical University,Hebei 067000,China)
出处
《医学研究杂志》
2021年第1期80-85,共6页
Journal of Medical Research
基金
河北省科学技术厅指令性计划项目(17277769D)。
