清晨高血压患者中性粒细胞/淋巴细胞比值与颈动脉粥样硬化的相关性
作者:
作者单位:

(承德医学院附属医院全科医学科,河北省承德市 067000)

作者简介:

舒谦,硕士研究生,研究方向为动脉硬化,E-mail:1437945529@qq.com。

基金项目:

河北省科技厅重点研发项目(223777112D);河北省自然科学基金资助项目(H2022406052);承德市科学技术研究与发展计划任务书(2021098057);2022年河北省政府资助优秀人才项目经费支持


Correlation between neutrophil/lymphocyte ratio and carotid atherosclerosis in patients with hypertension in the morning
Author:
Affiliation:

Department of General Practice, the Affiliated Hospital of Chengde Medical College, Chengde, Hebei 067000, China)

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    摘要:

    目的]探讨清晨高血压患者颈动脉粥样硬化(CAS)与中性粒细胞/淋巴细胞比值(NLR)的相关性,构建清晨高血压患者发生CAS风险的列线图预测模型。 [方法]连续收集2019年10月—2022年11月于承德医学院附属医院住院的清晨高血压患者255例,采集患者基本资料、血常规及血生物化学指标,所有入选患者均需完善24 h动态血压监测、颈动脉彩超检测,依据有无CAS将入选患者分为清晨高血压伴CAS组197例(简称伴CAS组)和清晨高血压不伴CAS组58例(简称不伴CAS组),采用多因素Logistic回归分析探讨清晨高血压伴CAS的危险因素,并据此构建和验证个体化预测清晨高血压患者伴CAS风险的列线图模型。 [结果]与不伴CAS组患者相比,伴CAS组年龄、NLR、中性粒细胞(NE)、单核细胞(MO)、白细胞(WBC)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)均显著升高,而高密度脂蛋白胆固醇(HDLC)显著下降(P<0.05)。多因素Logistic回归分析结果显示伴CAS组较不伴CAS组相比,年龄、NLR、TC升高,HDLC降低,年龄、NLR、TC是清晨高血压伴CAS的独立危险因素,而HDLC是其独立保护因素。基于多因素Logistic回归分析结果构建个体化预测清晨高血压伴CAS的列线图模型,采用Hosmer Lemeshow测试拟合度,检验结果为χ2=1.665(P>0.05)。该列线图模型的ROC曲线下面积为0.853(95%CI:0.802~0.904,P<0.01)。 [结论]NLR与清晨高血压伴CAS呈正相关,NLR是清晨高血压伴CAS的独立危险因素。基于年龄、NLR、TC、HDLC构建的个体化列线图模型可有效预测清晨高血压伴CAS的风险,为早期更加便捷发现和预防动脉粥样硬化提供了一定的理论依据。

    Abstract:

    Aim To explore the correlation between carotid atherosclerosis (CAS) and neutrophil/lymphocyte ratio (NLR) in patients with early morning hypertension, and to construct a line chart model to predict the risk of CAS in patients with hypertension in the morning. Methods 255 patients with early morning hypertension hospitalized in the Affiliated Hospital of Chengde Medical College from October 2019 to November 2022 were collected, and their basic data, blood routine and blood biochemical indexes were collected. All selected patients need to improve 24-hour ambulatory blood pressure monitoring and carotid artery color ultrasound detection. According to the presence or absence of CAS, all selected patients were divided into morning hypertension with CAS group (n=197) and morning hypertension without CAS group (n=58). Multivariate Logistic regression analysis was used to explore the risk factors of early morning hypertension with CAS, and to construct and verify an individual line chart model to predict the risk of early morning hypertension patients with CAS. Results The age, NLR, neutrophils (NE), monocytes (MO), white blood cell (WBC), total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDLC) increased in the early morning hypertension with CAS group compared with those in the morning hypertension group without CAS, while the HDLC decreased(P<0.05). The results of multivariate Logistic regression analysis showed that the age, NLR and TC were higher in the early morning hypertension with CAS group than those in the early morning hypertension without CAS group, while HDLC was lower; Age, NLR and TC were independent risk factors of early morning hypertension with CAS, while HDLC was independent protective factors of morning hypertension with CAS. Based on the results of multivariate Logistic regression analysis, an individualized line chart model for predicting early morning hypertension with CAS was constructed. The area under the ROC curve of the line chart model was 0.853 (95%CI:0.802~0.904, P<0.01). The result of Hosmer Lemeshow fit test was χ2=1.665 (P>0.05). Conclusions There was a positive correlation between NLR and morning hypertension with CAS, and NLR was an independent risk factor for morning hypertension with CAS. The individualized line chart model based on age, NLR, TC and HDLC can effectively predict the risk of hypertension with CAS in the early morning, which provides a theoretical basis for early detection and prevention of atherosclerosis.

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舒谦,赵翠,冯玉梅,蒋海森,曹亚文,李伟,辛秋平,郭翔宇.清晨高血压患者中性粒细胞/淋巴细胞比值与颈动脉粥样硬化的相关性[J].中国动脉硬化杂志,2024,32(11):979~984, 993.

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  • 收稿日期:2024-03-11
  • 最后修改日期:2024-05-19
  • 在线发布日期: 2024-11-22