单核细胞/高密度脂蛋白胆固醇比值与绝经后女性冠心病患者急性心力衰竭的关系  

Relationship between monocyte to high density lipoprotein cholesterol ratio and acute heart failure in postmenopausal women with coronary heart disease

作　　者：王莹[1] 吴少敏 马贵洲[1] 蔡志雄[1] 郭海森[1] WANG Ying;WU Shaomin;MA Guizhou;CAI Zhixiong;GUO Haisen(Department of Cardiovasology,Shantou Central Hospital,Shantou,Guangdong 515031;Department of Rehabilitation Medicine,Shantou Central Hospital,Shantou,Guangdong 515031,China)

机构地区：[1]汕头市中心医院心血管内科,广东省汕头市515031 [2]汕头市中心医院康复医学科,广东省汕头市515031

出　　处：《中国动脉硬化杂志》2020年第10期899-904,共6页Chinese Journal of Arteriosclerosis

基　　金：2018年度汕头市第六批医疗卫生科技计划(自筹经费类)项目(汕府科[2019]11号-8);2019年度汕头市第五批医疗卫生科技计划(财政资金支持类)项目(汕府科[2019]106号-20);2018年广东省科技创新战略专项资金(纵向协同管理方向)项目(汕府科[2018]157号-42)。

摘　　要：目的探讨入院时基线水平单核细胞/高密度脂蛋白胆固醇比值(MHR)与绝经后女性冠心病患者住院期间发生急性心力衰竭(AHF)的关系。方法入组2014年12月—2016年7月在汕头市中心医院接受冠状动脉造影术确诊为冠心病的绝经后女性180例,根据住院期间是否出现AHF分为两组:AHF组(n=55)和对照组(n=125)。采用Logistic回归分析MHR与AHF的关系。结果 AHF组MHR水平[0.48(0.31,0.61)]比对照组[0.35(0.23,0.44)]升高(P=0.005)。Spearman相关分析显示MHR与左心室射血分数(LVEF)呈负相关(r=-0.304,P=0.001)。校正年龄后,MHR与LVEF仍呈负相关(r=-0.215,P=0.005)。MHR预测绝经后女性冠心病患者住院期间发生AHF的最佳截点是0.367 7(特异度70.6%,灵敏度59.8%,曲线下面积0.646,标准误0.048,P=0.003,95%CI 0.551~0.740)。多因素Logistic回归分析显示绝经后女性冠心病患者住院期间发生AHF的独立危险因素包括MHR(OR 2.560,95%CI 1.141~5.743,P=0.023)、糖尿病(OR 2.245,95%CI 1.012~4.977,P=0.047)、脑钠肽(OR 5.518,95%CI 2.140~14.226,P<0.001)和血清肌酐(OR 1.014,95%CI 1.001~1.026,P=0.032)。结论 MHR是绝经后女性冠心病患者住院期间发生AHF的独立预测因子。Aim To investigate the relationship between baseline monocyte to high density lipoprotein cholesterol ratio(MHR)and acute heart failure(AHF)in postmenopausal women with coronary heart disease(CHD).Methods A cohort of 180 postmenopausal women was enrolled,who were diagnosed as CHD by coronary angiography in Shantou Central Hospital(Shantou,China)from December 2014 to July 2016.The patients were categorized into two groups:fifty-five patients with AHF in hospital as AHF group,one hundred and twenty-five patients without AHF as control group.The relationship between MHR and AHF was assessed by Logistic regression analysis.Results MHR in AHF group(0.48(0.31,0.61))was higher than that in control group(0.35(0.23,0.44))(P=0.005).MHR was negatively correlated with left ventricular ejection fraction(LVEF)by Spearman rank correlation analysis(r=-0.304,P=0.001)and partial correlation analysis by controlling for age(r=-0.215,P=0.005).The optimal MHR cut-off level for predicting AHF in postmenopausal women with CHD was 0.3677(specificity 70.6%,sensitivity 59.8%,area under the ROC curve 0.646,standard error 0.048,P=0.003,95%CI 0.551~0.740).Multivariate Logistic regression analysis showed that the independent risk factors of AHF included MHR(OR 2.560,95%CI 1.141~5.743,P=0.023),diabetes mellitus(DM)(OR 2.245,95%CI 1.012~4.977,P=0.047),brain natriuretic peptide(BNP)(OR 5.518,95%CI 2.140~14.226,P<0.001)and serum creatinine(OR 1.014,95%CI 1.001~1.026,P=0.032).Conclusion MHR is an independent predictor of AHF during hospitalization in postmenopausal women with CHD.

关 键 词：单核细胞/高密度脂蛋白胆固醇比值 急性心力衰竭 绝经后女性 冠心病 

分 类 号：R5[医药卫生—内科学]