单核细胞计数/高密度脂蛋白胆固醇比值与早发冠心病的相关性分析  

The relationship between monocyte to high-density lipoprotein cholesterol ratio and premature coronary heart disease

作　　者：徐慧[1] 刘芳[1] XU Hui;LIU Fang(Department of Geriatrics,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai,200092)

机构地区：[1]上海交通大学医学院附属新华医院老年科,上海200092

出　　处：《临床心血管病杂志》2020年第8期709-713,共5页Journal of Clinical Cardiology

摘　　要：目的:评估单核细胞/高密度脂蛋白胆固醇比值(MHR)对早发冠心病及冠状动脉(冠脉)狭窄程度的预测价值。方法:回顾性纳入2018年10月-2019年4月于上海交通大学医学院附属新华医院住院并首次行冠脉造影检查者共232例(男性≤55岁,女性≤65岁)。收集所有入组者的基本资料、实验室数据、冠脉造影结果。将入组患者分为早发冠心病组(126例)及无冠心病组(106例);另根据Gensini评分将早发冠心病组患者分为低分组(41例)、中间分组(43例)和高分组(42例)。比较各组间资料的差异,并运用Logistic回归及ROC曲线评估MHR对早发冠心病及冠脉狭窄程度的预测价值。结果:Logistics回归分析显示,高血压、糖化血红蛋白(HbA1C)、MHR、中性粒细胞与低密度脂蛋白胆固醇比值(NLR)为早发冠心病的独立危险因素。Spearman相关性分析显示,MHR与Gensini评分呈正相关性(r=0.664,P<0.001)。ROC曲线显示,MHR预测高Gensini评分的曲线下面积(AUC)为0.813(95%CI:0.740~0.886,P<0.001),截断值为0.362,灵敏度和特异度分别为69.05%和92.86%。结论:MHR可作为早发冠心病的独立危险因素,并与冠脉狭窄程度呈正相关。Objective:To investigate the relationship of monocyte counts to high-density lipoprotein cholesterol ratio(MHR)with premature coronary heart disease(PCHD)and the severity of the coronary lesion.Method:A total of 232 patients(male≤55 and female≤65 years old)who received coronary angiography for the first time in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from October 2018 to April 2019 were included.General clinical data,laboratory information and coronary angiography results of all participants were collected.All subjects were divided into PCHD group(n=126)and non-CHD group(n=106),then patients in PCHD group were further divided into low(n=41),median(n=43)and high(n=42)score group according to the Gensini score.The differences among groups were compared,and the predictive value of MHR for PCHD and the severity of coronary lesion was evaluated by Logistic regression and ROC analysis.Result:Logistic regression analysis showed that hypertension,HbA1 c,MHR,the ratio of neutrophils to low-density lipoprotein cholesterol(NLR)were independent risk factors of PCHD.Spearman correlation analysis showed that MHR was positively related to the Gensini score(r=0.664,P<0.001).ROC analysis showed that the area under the curve(AUC)of MHR in predicting a high Gensini score was 0.813(95%CI:0.740-0.886,P<0.001),the cutoff value was0.362,the sensitivity and specificity were 69.05%and 92.86%respectively.Conclusion:MHR is an independent risk factor for PCHD,and is positively correlated with the severity of coronary lesions.

关 键 词：冠心病 早发 单核细胞/高密度脂蛋白胆固醇比值 冠状动脉狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]