NLR VLDL TPP与CABG术后静脉桥血管狭窄类病变的关联性及联合预测价值  

Correlations of NLR,VLDL and TPP with post-CABG venous bridge vascular stenosis lesion and the value of combined prediction

作　　者：翟少峰 王永生[1] 张宪芬[1] 韩婉青 张俊伟[1] Zhai Shaofeng;Wang Yongsheng;Zhang Xianfen;Han Wanqing;Zhang Junwei(The First Affiliated Hospital(Clinical College)of Henan University of Science and Technology,Luoyang 471000,Henan,China)

机构地区：[1]河南科技大学第一附属医院(河南科技大学临床学院),河南洛阳471000

出　　处：《临床心身疾病杂志》2023年第5期57-62,共6页Journal of Clinical Psychosomatic Diseases

基　　金：河南省医学科技攻关计划项目(编号2018092166)。

摘　　要：目的 探讨中性粒细胞与淋巴细胞比值、极低密度脂蛋白、血栓前体蛋白与冠状动脉旁路移植术后静脉桥血管狭窄类病变的关联性及联合预测分析。方法 将125例行冠状动脉旁路移植术患者根据冠状动脉造影检查结果分为狭窄组70例,非狭窄组55例,比较两组基线资料、中性粒细胞与淋巴细胞比值、极低密度脂蛋白、血栓前体蛋白,采用Pearson积矩相关分析中性粒细胞与淋巴细胞比值、极低密度脂蛋白、血栓前体蛋白与静脉桥血管狭窄程度的关系,采用多元线性回归模型分析冠状动脉旁路移植术后静脉桥血管狭窄类病变的影响因素,绘制受试者工作特征曲线分析各指标预测静脉桥血管狭窄类病变的价值,并比较不同情况中性粒细胞与淋巴细胞比值、极低密度脂蛋白、血栓前体蛋白水平患者静脉桥血管狭窄类病变发生率。结果 狭窄组高脂血症占比、中性粒细胞与淋巴细胞比值、极低密度脂蛋白、血栓前体蛋白均高于非狭窄组,冠状动脉造影距冠状动脉旁路移植时间长于非狭窄组,复查冠状动脉造影狭窄程度高于非狭窄组,术后遵医用药率低于非狭窄组,差异有统计学意义(P<0.05或0.01)。中性粒细胞与淋巴细胞比值、极低密度脂蛋白、血栓前体蛋白与静脉桥血管狭窄程度呈正相关(P<0.01),是静脉桥血管狭窄程度的相关影响因素(P<0.01)。受试者工作特征曲线显示,各指标联合预测静脉桥血管狭窄类病变的曲线下面积值大于单一检测(P<0.01);中性粒细胞与淋巴细胞比值、极低密度脂蛋白、血栓前体蛋白高危患者静脉桥血管狭窄类病变发生率高于低危患者(P<0.01)。结论 中性粒细胞与淋巴细胞比值、极低密度脂蛋白、血栓前体蛋白水平与冠状动脉旁路移植术后静脉桥血管狭窄类病变密切相关,对其发生风险具有一定预测价值,有望从细胞及分子学水平为静脉桥疾病治疗Objective To explore the correlations of neutrophil-to-lymphocyte ratio(NLR),very low density lipoprotein(VLDL),and thrombus precursor protein(TPP)with venous bridge stenosis lesion(VBSL)after coronary artery bypass graft(CABG)and the value of combined prediction.Methods A total of 125 patients undergoing the CABG were assigned to stenosis(n=70)and non-stenosis(n=55)group according to coronary angiography results,such indexes were compared between two groups as baseline information,NLR,VLDL and TPP,the correlations of NLR,VLDL and TPP with the degrees of the VBSL analyzed using Pearson correlation coefficient model,influencing factors of the VBSL after CABG explored using multiple linear regression model,values of each index predicting the VBSL analyzed by drawing receiver operator characteristic(ROC)curve,and the incidence rates of the VBSL compared among-patients with different NLR,VLDL and TPP.Results Hyperlipidemia,NLR,VLDL and TPP were all higher,grafting times less,stenosis degrees of re-examining coronary angiography narrower,and post-operative medication compliance rates lower in stenosis group than non-stenosis group,differences statistically significant(P<0.05 or 0.01).NLR,VLDL and TPP were positively correlated with the degrees of stenosis(P<0.01)and were factors influencing the degrees of stenosis(P<0.01).The ROC showed that area under the curve of combined each index predicting the VBSL was larger compared with single index prediction(P<0.01);incidence of the VBSL were higher in high-risk NLR,VLDL and TPP patients than low-risk ones(P<0.01).Conclusion The levels of NLR,VLDL,and TPP are closely related to the VBSL and have a certain predictive value for occurrent risk of the VBSL,it is expected to provide new research directions for venous bridging diseases from the cellular and molecular level.

关 键 词：中性粒细胞与淋巴细胞比值 极低密度脂蛋白 血栓前体蛋白 冠状动脉旁路移植术 静脉桥血管狭窄类病变 关联性 预测价值 

分 类 号：R541.4[医药卫生—心血管疾病]