脂蛋白相关磷脂酶A2、中性粒细胞/淋巴细胞比值与2型糖尿病合并冠心病患者预后的关系  

Relationship between lipoprotein-associated phospholipase A2 and neutrophil/lymphocyte ratio and the prognosis of type 2 diabetes mellitus combined with coronary heart disease

作　　者：张明[1] 侯建伟[1] 梁蒙[1] 邱军杰[1] ZHANG Ming;HOU Jian-wei;LIANG Meng;QIU Jun-jie(Department of Cardiology,the Second Affiliated Hospital of Xi'an Medical College,Shaanxi Provincial Cardiology Medical Research Center,Xi'an 710038,China)

机构地区：[1]西安医学院第二附属医院心内科陕西省心血管内科疾病临床医学研究分中心,西安710038

出　　处：《中国医学前沿杂志（电子版）》2018年第10期36-40,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：陕西省教育厅专项项目基金(16JK1667)

摘　　要：目的分析脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)、中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)与2型糖尿病(type 2 diabetes mellitus,T2DM)合并冠心病患者预后的关系。方法检测并比较本院2016年5月至2018年3月收治的单纯T2DM患者(T2DM组,58例)、未合并糖尿病的冠心病患者(冠心病组,62例)、T2DM合并冠心病患者(T2DM合并冠心病组,65例)及同期入院健康体检者(对照组,30例)的血清Lp-PLA2水平、中性粒细胞计数、淋巴细胞计数、NLR,以及T2DM合并冠心病组不同预后[是否出现主要不良心脏事件(major adverse cardiac events,MACE)]患者上述指标水平,分析T2DM合并冠心病患者发生MACE的危险因素。结果 T2DM合并冠心病组患者血清Lp-PLA2水平、中性粒细胞计数、NLR均明显高于T2DM组、冠心病组及对照组(P_均<0.05),T2DM组、冠心病组、对照组研究对象上述指标水平比较差异亦具有显著性(P_均<0.05),冠心病组、T2DM合并冠心病组患者淋巴细胞计数均显著低于T2DM组和对照组(P_均<0.05);T2DM合并冠心病组半年内出现MACE患者血清Lp-PLA2水平、中性粒细胞计数、NLR均显著高于本组未出现MACE患者(P_均<0.05),淋巴细胞计数显著低于本组未出现MACE患者(P<0.05)。单因素及多因素Logistic回归分析结果显示,Lp-PLA2、NLR是T2DM合并冠心病患者出现MACE的独立危险因素(P_均<0.05)。结论血清Lp-PLA2水平、NLR与T2DM合并冠心病患者预后密切相关,Lp-PLA2水平和NLR越高预示患者预后越差。Objective To analyze the relationship between lipoprotein-associated phospholipase A2(Lp-PLA2)and neutrophil/lymphocyte ratio(NLR)and the prognosis of type 2 diabetes mellitus(T2DM)with coronary artery heart disease.Method The serum Lp-PLA2 level,neutrophil count,lymphocyte count and NLR in patients with simple T2DM(T2DM group,n=58),artery heart disease patients without T2DM(artery heart disease group,n=62),patients with T2DM and artery heart disease(T2DM combined with artery heart disease group,n=65)and healthy people(control group,n=30)were detected from May 2016 to March 2018 in our hospital.The above indicators were compared among patients with different prognosis[occurrence of major adverse cardiac events(MACE)]in T2DM combined with artery heart disease group.The risk factors of MACE occurrence in T2DM combined with artery heart disease were analyzed.Result The serum Lp-PLA2 level,neutrophil count and NLR in T2DM combined with artery heart disease group were significantly higher than those in T2DM group(Pall<0.05),artery heart disease group and control group,and the differences in the above indexes were statistically significant among T2DM group,artery heart disease group and control group(Pall<0.05),and the lymphocyte count in artery heart disease group and T2DM combined with artery heart disease group was lower than that in T2DM group and control group(Pall<0.05).In T2DM combined with artery heart disease group,the serum Lp-PLA2 level,neutrophil count and NLR in MACE occurrence patients were higher than those in MACE non-occurrence patients within half a year(Pall<0.05),and the lymphocyte count was lower than MACE non-occurrence(P<0.05).Univariate and multivariate Logistic regression analysis showed that Lp-PLA2 level and NLR were independent risk factors of MACE in T2DM patients combined with artery heart disease(Pall<0.05).Conclusion Serum Lp-PLA2 level and NLR are closely related to the prognosis of T2DM patients combined with artery heart disease.The higher the Lp-PLA2 level and NLR,the worse the progn

关 键 词：脂蛋白相关磷脂酶A2 中性粒细胞/淋巴细胞比值 2型糖尿病 冠心病 预后 

分 类 号：R541.4[医药卫生—心血管疾病]