冠心病患者单核细胞/淋巴细胞比率与冠状动脉病变严重程度的相关性分析
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(1.湖北省中医院心内科,湖北省武汉市 430061;2.湖北省中医药研究院心内科,湖北省武汉市 430074;3.湖北中医药大学附属医院心内科,湖北省武汉市 430061;4.湖北中医药大学第一临床学院内科教研室,湖北省武汉市 430061)

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柳强,硕士,主治医师,研究方向为中西医结合防治心血管病,E-mail为leonjordan23@sina.com.cn。通信作者薛雪,硕士,讲师,研究方向为中医药防治内科疾病,E-mail为xue025004138@163.com。

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国家中医药管理局全国名老中医药专家传承工作室建设项目(财社[2013]135号)


Analysis of correlation between monocyte to lymphocyte ratio and lesion severity of coronary artery in patients with coronary heart disease
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1.Department of Cardiology, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, Hubei 430061, China;2.Department of Cardiology, Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan, Hubei 430074, China;3.Department of Cardiology, Affiliated Hospital of Hubei University of Traditional Chinese Medicine, Wuhan, Hubei 430061, China;4.Teaching and Research Department of Internal Medicine, First Clinical College, Hubei University of Traditional Chinese Medicine, Wuhan, Hubei 430061, China)

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    摘要:

    目的 探讨冠心病患者单核细胞/淋巴细胞比率(MLR)与冠状动脉病变严重程度的相关性及其预测价值。方法 选取2018年1月至12月在湖北省中医院花园山院区心内科住院并行冠状动脉造影的患者203例作为研究对象。将161例确诊冠心病的患者按照冠状动脉病变严重程度(Gensini评分)分为轻度病变组、中度病变组及重度病变组;再将161例冠心病患者按照MLR三分位数分成3组。对照组42例,冠状动脉造影显示冠状动脉正常或狭窄程度小于50%。用Logistic逐步回归方法及受试者工作特征曲线(ROC)分析冠心病患者MLR与冠状动脉病变严重程度的相关性及其预测价值。结果 ①MLR三分位组间比较,第2三分位组、第3三分位组冠状动脉病变积分较第1三分位组明显升高(P=0.022,P=0.001)。②Spearman相关分析显示,MLR水平与冠心病患者冠状动脉病变程度呈正相关(r=0.281,P<0.01);Kendall相关分析亦显示二者呈正相关(r=0.188,P<0.01)。③Logistic逐步回归分析显示吸烟史、高龄、MLR、载脂蛋白B是冠心病发病的独立危险因素,载脂蛋白A1则是冠心病的保护性因素。④ROC曲线分析显示,MLR的曲线下面积为0.709(95%CI:0.621~0.797)。当MLR临界值取0.186时,其诊断冠心病效能最高,敏感性为82.6%,特异性为50.0%。结论 炎症在冠心病的发病过程中发挥了至关重要的作用,MLR作为独立危险因素之一,对冠心病有预测价值。

    Abstract:

    Aim To investigate the correlation between monocyte to lymphocyte ratio (MLR) and lesion severity of coronary artery in patients with coronary heart disease (CHD) and its predictive value. Methods 203 patients with coronary angiography in the Department of Cardiology of Huayuan Mountain Branch of Hubei Provincial Hospital of Traditional Chinese Medicine from January to December 2018 were selected as the study subjects. 161 patients with CHD were divided into mild lesion group, moderate lesion group and severe lesion group according to the severity of coronary artery lesion (Gensini score). 161 patients with CHD were further divided into three groups according to the MLR three-quantile.In 42 cases of control group, coronary angiography showed that the normal coronary or stenosis degree of coronary artery was less than 50%. Logistic stepwise regression and receiver operating characteristic curve (ROC) were used to analyze the correlation between MLR and lesion severity of coronary artery in CHD patients and its predictive value. Results (1)Inter-group comparison of MLR three-quantile, coronary artery lesion score in the second three-quantile group and third three-quantile group was significantly higher than that in the first three-quantile group (P=0.022, P=0.001). (2)Spearman correlation analysis showed that MLR level was positively correlated with the severity of coronary artery lesions in CHD patients (r=0.281, P<0.01); Kendall correlation analysis also showed a positive correlation between MLR level and the severity of coronary artery lesions in CHD patients (r=0.188, P<0.01). (3)Logistic stepwise regression analysis showed that smoking history, old age, MLR and apolipoprotein B were independent risk factors for CHD, while apolipoprotein A1 was a protective factor for CHD. (4)ROC curve analysis showed that the area under curve of MLR was 0.709 (95%CI:0.621-0.797). When the cut-off value of MLR was 0.186, the diagnostic efficacy of MLR for CHD was the highest, with a sensitivity of 82.6% and a specificity of 50.0%. Conclusions Inflammation plays an important role in the pathogenesis of CHD. As an independent risk factor, MLR has predictive value for CHD.

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柳强,胡有志,薛雪.冠心病患者单核细胞/淋巴细胞比率与冠状动脉病变严重程度的相关性分析[J].中国动脉硬化杂志,2019,27(10):868~873.

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  • 收稿日期:2019-03-06
  • 最后修改日期:2019-04-28
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  • 在线发布日期: 2019-09-19