中性粒细胞与淋巴细胞比值与冠状动脉临界病变患者斑块易损性的相关性研究  

Correlation between neutrophil-lymphocyte ratio and plaque vulnerability in patients with coronary artery disease

作　　者：周蓉 樊蓉 沈霞蔚[1] Zhou Rong;Fan Rong;Shen Xiawei(Department of Cardiology,the First People's Hospital ofJingzhou,Jingzhou 434099,China)

机构地区：[1]湖北省荆州市第一人民医院心内科,荆州434099

出　　处：《中国循证心血管医学杂志》2019年第2期230-233,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的分析中性粒细胞与淋巴细胞比值(NLR)与冠状动脉(冠脉)临界病变患者斑块易损性的相关性。方法回顾性分析湖北省荆州市第一人民医院心内科自2017年2月至2018年2月经冠脉造影确诊的138例冠脉临界病变患者的临床资料,根据血管内超声(IVUS)检查结果,分为易损斑块组(65例)和稳定斑块组(73例);入院即通过实验室检查获得外周血并计算NLR,次日清晨采样并检测血清超敏C-反应蛋白(hs-CRP)、尿液肝型脂肪酸结合蛋白(L-FABP);通过IVUS评估冠脉内斑块形态及组织成分;比较两组NLR、hs-CRP、L-FABP水平、IVUS灰阶及虚拟组织学成像(VH)结果。结果易损斑块组NLR、hs-CRP、L-FABP水平均高于稳定斑块组,差异均有统计学意义(P<0.05);两组斑块面积、管腔面积、血管重塑指数、斑块负荷占比比较,差异均无统计学意义(P>0.05);易损斑块组斑块偏心指数、坏死核心占比、钙化组织占比均显著大于稳定斑块组,纤维组织占比及脂肪组织占比均小于稳定斑块组,差异均有统计学意义(P<0.05);冠脉临界病变患者NLR与hs-CRP、L-FABP及脂肪组织占比均呈正相关(P<0.05),NLR与纤维组织占比呈负相关(r=0.32,P<0.05);ROC曲线显示NLR预测易损斑块的分界值为2.779,敏感度为76.81%,特异度为93.94%。结论 NLR与冠脉临界病变患者斑块易损性有关,有望成为预测易损斑块的简易有效指标,值得进一步研究应用。Objective To analyze the relationship between neutrophil/lymphocyte ratio(NLR)and plaque vulnerability in coronary artery(CA)critical lesions.Methods Clinical data of 138 patients with coronary artery lesions diagnosed by coronary angiography from February 2017 to February 2018 in Department of Cardiology,Jingzhou First People's Hospital were analyzed.According to the results of the intravascular ultrasound(IVUS)test,the 138 patients were divided into vulnerable plaque group(65 cases)and stable plaque group(73 cases).Peripheral blood was obtained by laboratory examination at admission and NLR was calculated.Serum hypersensitive C-reactive protein(hs-CRP)and urine hepatic fatty acid binding protein(L-FABP)were sampled the next morning;coronary artery was assessed by IVUS The morphology and tissue composition of the plaques were compared;the NLR,hs-CRP,L-FABP levels,IVUS gray scale and virtual histological imaging(VH)results were compared between the two groups.Results The levels of NLR,hs-CRP and L-FABP in the vulnerable plaque group were significantly higher than those in the stable plaque group,and the differences were statistically significant(P<0.05).There was no significant difference in plaque area,lumen area,vascular remodeling index,and plaque load ratio between the two groups(P>0.05).The eccentricity index,the proportion of necrotic core and the proportion of calcified tissue in the vulnerable plaque group were significantly larger than those in the stable plaque group,proportion of fibrous tissue and the proportion of adipose tissue were significantly smaller than those of the stable plaque group,the difference was statistically significant(P<0.05).There was a positive correlation between NLR and hs-CRP,L-FABP and adipose tissue in critical coronary artery lesions(all P<0.05),and negative correlation between NLR and fibrous tissue(r=0.32,P<0.05).The ROC curve showed that the demarcation value of NLR predicting vulnerable plaque was 2.797,the sensitivity was 76.81%,and the specificity was 93.94%.Conclusio

关 键 词：冠状动脉临界病变 中性粒细胞与淋巴细胞比值 斑块易损性 血管内超声 

分 类 号：R543.3[医药卫生—心血管疾病]