中性粒细胞和白蛋白比值对急性冠脉综合征的诊断价值研究  

The Diagnostic Value of Neutrophil to Albumin Ratio in Acute Coronary Syndrome

作　　者：汪彪[1] 陈见红[1] WANG Biao;CHEN Jianhong(Department of Cardiovascular,Liuzhou People's Hospital,Liuzhou Guangxi 545001,China)

机构地区：[1]柳州市人民医院心血管内科,广西柳州545001

出　　处：《中国卫生标准管理》2022年第16期115-119,共5页China Health Standard Management

基　　金：柳州市科技局计划项目(2021CBC0112)。

摘　　要：目的比较急性冠脉综合征(acute coronary syndrome,ACS)患者和对照组中性粒细胞与白蛋白比值(neutrophil to albumin ratio,NAR)、血小板和白蛋白比值(platelet to albumin ratio,PAR)和单核细胞和白蛋白比值(monocyte to albumin ratio,MAR)的差异,并探讨其对ACS的诊断价值。方法选择2018年1—12月于本院就诊的ACS患者164例为研究对象,匹配冠脉造影正常者105例为对照组。根据Killip分级将ACS患者分为重度心衰组(Killip≥3)和非重度心衰组(Killip<3)。比较各指标在ACS患者和对照组中的差异,用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析各指标对ACS的诊断价值。分析各指标与心肌损伤指标的相关性,进一步比较各指标在ACS亚组中的差异。结果ACS组中的中性粒细胞、单核细胞、血小板、MAR、NAR和PAR均高于对照组,白蛋白和淋巴细胞均低于对照组,差异均有统计学意义(P<0.05)。ROC分析结果显示NAR的曲线下面积(area under the curve,AUC)为0.914(0.875~0.952),高于其他指标。其中,NAR的最佳截断值为0.126,其对应的约登指数为0.721,敏感度为90.2%,特异度为81.9%。NAR均与酸激酶同工酶(creatine kinase isoenzymes,CKMB)、肌钙蛋白T(cardiac troponin T,cTnT)和肌钙蛋白Ⅰ(cardiac troponinⅠ,cTnI)呈正相关。重度心衰组的NAR、CKMB、c Tn T和c Tn I明显高于非重度心衰组,差异有统计学意义(P<0.05)。结论NAR在ACS患者及重度心衰ACS患者中明显上调,对ACS具有重要的诊断价值。Objective The neutrophil to albumin ratio(NAR)was compared between patients with acute coronary syndrome(ACS)and controls.NAR,platelet to neutrophil ratio(PAR)and monocyte to albumin ratio(MAR),and to investigate their diagnostic value for ACS.Methods A total of 164 ACS patients treated in our hospital from January to December 2018 were selected as the research objects,and 105 patients with normal coronary angiography were selected as the control group.According to Killip classification,ACS patients were divided into severe heart failure group(Killip≥3)and non-severe heart failure group(Killip<3).The differences of each index between ACS patients and control group were compared,and the diagnostic value of each index for ACS was analyzed by receiver operating characteristic curve(ROC)curve.The correlation between each index and myocardial injury index was analyzed,and the differences of each index in ACS subgroup were further compared.Results The levels of neutrophils,monocytes,platelets,MAR,NAR and PAR in ACS group were higher than those in control group,and the levels of albumin and lymphocytes in ACS group were lower than those in control group,and the differences were statistically significant(P<0.05).ROC analysis showed that the area under the curve(AUC)of NAR was 0.914(0.875-0.952),which was higher than other indicators.The optimal cut-off value of NAR was 0.126,the corresponding Youden index was 0.721,the sensitivity was 90.2%,and the specificity was 81.9%.NAR was positively correlated with creatine kinase isoenzymes,(CKMB),cardiac troponin T(cTnT)and cardiac troponinⅠ(cTnI).NAR was positively correlated with CKMB,cTnT and cTnI.The NAR,CKMB,cTnT and cTnI of the severe heart failure group were significantly higher than those of the non-severe heart failure group(P<0.05).Conclusion NAR is significantly up-regulated in ACS patients and ACS patients with severe heart failure,and has important diagnostic value for ACS.

关 键 词：中性粒细胞和白蛋白比值 急性冠脉综合征 血小板和中性粒细胞比值 单核细胞和白蛋白比值 诊断价值 标志物 

分 类 号：R541[医药卫生—心血管疾病]