血小板/淋巴细胞比值与冠状动脉侧支循环形成的相关性  

Association between platelet-to-lymphocyte ratio and coronary collateral circulation formation

作　　者：李本磊 钱成[1] 方冬 王扬淦[1] 

机构地区：[1]武汉大学中南医院心内科,湖北武汉430071 [2]华润武钢总医院心内科,湖北武汉430080

出　　处：《心脏杂志》2017年第5期547-551,共5页Chinese Heart Journal

摘　　要：目的探讨血小板/淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)与冠状动脉完全闭塞(chronic total occlusion,CTO)患者冠状动脉侧支循环(coronary collateral circulation,CCC)形成的关系。方法选取经造影确定主要冠状动脉至少1支存在CTO病变的患者137例,根据Rentrop分级标准对患者的CCC情况进行分级,进一步分为CCC形成不良组(Rentrop 0~Ⅰ级,n=57)和CCC形成良好组(RentropⅡ~Ⅲ级,n=80)。根据患者的血常规结果计算PLR值。结果两组患者的PLR分别为163±86和108±36,侧支形成不良组的PLR显著高于侧支形成良好组(P<0.01)。多因素Logistic回归分析表明,PLR是影响CCC形成的独立相关因素(OR:1.02,95%CI:1.008~1.032;P<0.01)。经ROC曲线获得的PLR预测CCC形成不良的曲线下面积为0.75(95%CI:0.67~0.84),与超敏C反应蛋白(hs-CRP)相当;当PLR截点取140.876时,其诊断效率最高,敏感度为61%,特异度为82%。结论在CTO患者中,PLR和CCC的形成相关,高PLR水平是预测CCC形成不良的独立相关因素,其预测价值与hs-CRP相当。AIM To investigate the relationship between the platelet-to-lymphocyte ratio （PLR） and the formation of coronary collateral circulation （CCC） in patients with coronary chronic total occlusion （CTO）. METHODS This study included 137 patients who underwent coronary angiograph in our hospital and were diagnosed as chronic total occlusion with at least one major coronary artery involved. The Rentrop grade system was utilized to clarify the collateral vessels as poor CCC （Rentrop 0-1） and good CCC （Rentrop 2-3）. PLR was calculated according to the results of routine blood test. RESULTS Of the enrolled patients, 57 were graded into the poor CCC group and 80 into the good CCC group. The PLR value was significantly higher in poor CCC group than in good CCC group （163±86 vs. 108±36, P〈0.01）. Multivariate logistic regression demonstrated that PLR was an independent predictor for poor CCC （OR： 1.02, 95%CI： 1.008-1.032; P〈0.01）. The ROC curve yielded an under curve area of 0.75 for PLR to predict impaired CCC formation, with PLR value〉140.876 indicating a sensitivity of 61% and a specificity of 82% for predicting CCC. CONCLUSION In patients with CTO, PLR is associated with the CCC formation and high PLR level is an independent predictor for poor CCC.

关 键 词：血小板/淋巴细胞比值 侧支循环 慢性完全闭塞 炎症 

分 类 号：R541.4[医药卫生—心血管疾病]