单核细胞计数/高密度脂蛋白胆固醇比值在评价老年高血压患者颈动脉粥样斑块形成中的意义  

Significance of monocyte count/high density lipoprotein cholesterol ratio in the evaluation of carotid atheromatous plaque formation in elderly patients with hypertension

作　　者：王启平 朱玉华 钱国权[2] Wang Qiping;Zhu Yuhua;Qian Guoquan(Department of Cardiology,People's Hospital of Changxing,Huzhou 313100,China;Department of Cardiology,Huzhou Central Hospital,Huzhou 313000,China)

机构地区：[1]浙江省湖州市长兴县人民医院心内科,313100 [2]浙江省湖州市中心医院心内科,313100

出　　处：《心脑血管病防治》2020年第6期579-583,共5页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的探讨单核细胞计数/高密度脂蛋白胆固醇比值(MHR)在评价老年高血压患者颈动脉粥样斑块形成的意义。方法回顾性收集2016年8月至2018年10月湖州市长兴县人民医院心内科收治的182例老年高血压患者的临床资料,按照颈动脉内膜中层厚度(IMT)分为A组(IMT<1.00 mm,64例)、B组(IMT为1.00~1.20 mm,65例)和C组(IMT>1.20 mm,53例)。比较三组一般临床资料及实验室检查指标的差异。结果三组在收缩压(SBP)、脉压(PP)、血尿酸(UA)、C反应蛋白(CRP)、白细胞计数(WBC)、单核细胞计数(MON)、血肌酐(Cr)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、MHR比较差异有统计学意义(F=4.171、7.645、5.805、7.283、3.199、16.114、9.277、6.452、16.370、32.741,P<0.05),C组SBP、PP、UA、MON、Cr、TG水平均高于B组和A组,HDL-C低于另两组,差异有统计学意义(P<0.05),C组CRP、WBC水平高于A组,差异有统计学意义(P<0.05)。C组MHR高于B组和A组(P<0.05),B组高于A组比较差异有统计学意义(P<0.05)。Logistic回归显示MHR是老年高血压颈动脉粥样斑块形成的危险因素(OR=2.113,95%CI=1.672~5.248,P<0.05)。ROC曲线显示MHR预测的曲线下面积为0.87,敏感度为79.65%,特异度为79.50%,最佳诊断值为0.48。以最佳诊断值将患者分为两组,MHR>0.48组IMT、Crouse斑块积分、斑块检出率均显著高于MHR≤0.48组,差异有统计学意义(t/χ^2=3.112、9.593、4.105,P<0.05)。结论MHR可能是老年高血压患者颈动脉粥样斑块形成的预测因子之一,且具有良好的预测价值,临床应当注意监测MHR以早期评估此类患者病情与预后。Objective To investigate the significance of monocyte count/high density lipoprotein cholesterol(HDL-C)ratio(MHR)in the evaluation of carotid atheromatous plaque formation in elderly patients with hypertension.Methods The clinical data of 182 elderly patients with hypertension admitted to the department of cardiology,Changxing county people's hospital from August 2016 to October 2018 were retrospectively collected.According to the carotid intima-media thickness(IMT),they were divided into group A(IMT<1.00 mm,64 cases),group B(IMT 1.00-1.20 mm,65 cases)and group C(IMT>1.20 mm,53 cases).The differences of general clinical data and laboratory examination indexes of the three groups were compared.Results The systolic blood pressure(SBP),pulse pressure(PP),uric acid(UA),C-reactive protein(CRP),white blood cell count(WBC),monocyte count(Mon),creatinine(Cr),triglyceride(TG),HDL-C and MHR of the three groups were statistically significant different(F=4.171,7.645,5.805,7.283,3.199,16.114,9.277,6.452,16.370,32.741,P<0.05).The levels of SBP,PP,UA,Mon,Cr and TG of group C were higher than those of group B and group A,the level of HDL-C was lower than those of the other two groups(P<0.05).The levels of CRP and WBC in group C were higher than those in group A(P<0.05).The MHR of group C was higher than that of group B and group A(P<0.05),and that of group B was higher than that of group A,the difference was statistically significant(P<0.05).Logistic regression showed that MHR was a risk factor for carotid atheromatous plaque formation in elderly patients with hypertension(OR=2.108,95%CI=1.667-5.238,P<0.05).ROC curve showed that the area under the curve predicted by MHR was 0.87,the sensitivity was 79.65%,the specificity was 79.50%,and the best diagnostic value was 0.48.The patients were divided into two groups according to the best diagnosis value.IMT,crouse plaque score and plaque detection rate of MHR>0.48 group were significantly higher than those of MHR≤0.48 group,the differences were statistically significant(t/χ^2=3.11

关 键 词：单核细胞计数/高密度脂蛋白胆固醇比值 老年人 高血压 颈动脉粥样斑块形成 

分 类 号：R544.1[医药卫生—心血管疾病]