新疆伊犁哈萨克族人群NLR与冠心病及冠状动脉病变程度相关性研究  

Association of neutrophil to lymphocyte ratio with coronary heart disease and the extent of coronary atherosclerosis in kazak population from Ili Kazakh Autonomous Prefecture

作　　者：宋海峰 巫刚 孙德醒 SONG Hai-feng;WU Gang;SUN De-xing(Department of Outpatient,Chinese PLA 946 Hospital,Yining 835000,Xinjiang,China;Department of Cardiology,Chinese PLA 946 Hospital,Yining 835000,Xinjiang,China)

机构地区：[1]解放军陆军第九四六医院门诊部,伊宁835000 [2]解放军陆军第九四六医院心内科,伊宁835000

出　　处：《东南国防医药》2021年第5期493-496,共4页Military Medical Journal of Southeast China

摘　　要：目的探讨新疆伊犁哈萨克族人群中外周血中性粒细胞/淋巴细胞比值(NLR)与冠状动脉病变的关系,并评测其对冠状动脉粥样硬化性心脏病(冠心病)的预测价值。方法回顾性分析2018年1月至2019年12月在解放军陆军第九四六医院心内科住院的行冠状动脉造影术新疆伊犁哈萨克族患者210例的临床资料。收集首次入院血常规和血生化检查结果并获得NLR值,常规经桡动脉或股动脉完成选择性心脏冠脉造影,诊断冠心病并运用Gensini积分法对冠脉狭窄进行系统性评价,依据Gensini积分进行分组。将NLR和Gensini积分进行相关性检验,进一步运用ROC曲线评测NLR对冠心病的预测价值。结果单因素方差分析显示,随着Gensini积分的逐级增高,NLR在组间的差异有统计学意义,也表现出逐级增高的趋势(P<0.05)。将NLR和Gensini积分用Spearman法分析发现两者呈现正相关(r=0.478,P<0.001)。逐步多元线性回归分析发现,NLR、血糖和年龄共同决定Gensini积分25.8%的变化(β=3.591、5.477、0.632,P<0.05)。新疆伊犁哈萨克族人群中NLR>2.19对于预测冠心病的敏感性为59%,特异性为73%[AUC(95%CI):0.671(0.562~0.779),P<0.01]。结论在伊犁哈萨克族人群,NLR可以作为评测冠脉病变程度和诊断冠心病的简易预测指标。Objective To explore the relationship between NLR with coronary artery disease and the degree of coronary atherosclerosis in kazak population from Ili Kazakh Autonomous Prefecture.Methods 210 patients with coronary angiography were enrolled in Chinese PLA 946 Hospital.Routine blood test was performed on admission and NLR value was calculated before coronary angiography.Taking positive coronary angiography(stenosis of major vessels≥50%)as the diagnostic standard of coronary artery disease.Totally,24 healthy subjects were enrolled as a control group.The Gensini scoring system was used to assess the severity and complexity of coronary artery disease.Patients were divided into mild,moderate and severe lesion groups based on the Gensini score.The relations of age,Body Mass Index(BMI),blood pressure,triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),glucose and NLR were analyzed by One-Way ANOVA.The relationship between NLR level and Gensini score was analyzed by spearman correlation analysis and multiple linearregression.The value of NLR in predicting coronary artery disease was assessed by ROC curve.Results The NLR level of CHD group was significantly higher than that of normal control group(P<0.05),and the NLR level showed a gradually increasing trend between groups(P<0.05).NLR was positively correlated with the Gensini score(r=0.478,P<0.001).Multiple linear regression analysis showed NLR,glucose and age accounted for 25.8%of the variation of the Gensini score(β=3.591,5.477,0.632,P<0.05).A NLR=2.19 as optimal cut-off value,with sensitivity of 59%and specificity of 73%(AUC:0.671,95%CI:0.562-0.779,P<0.01)in predicting coronary artery disease.Conclusion As an independent risk factor for the degree of coronary artery stenosis,NLR can also predict the occurrence of coronary heart disease in kazak population of Ili Kazakh Autonomous Prefecture.

关 键 词：伊犁哈萨克族 中性粒细胞/淋巴细胞比值 GENSINI积分 冠状动脉粥样硬化性心脏病 

分 类 号：R541.4[医药卫生—心血管疾病]