外周血PLR、LDL、Hcy水平与老年高血压患者颈动脉斑块形成及稳定性的关系分析  

Analysis of the relationship between peripheral blood PLR,LDL,and Hcy levels and carotid plaque formation and stability in elderly hypertensive patients

作　　者：牛家龙 李可立 石晓燕[1] NIU Jia-long;LI Ke-li;SHI Xiao-yan(Department of General Practice,Huangshan People's Hospital,Huangshan Anhui 245000,China)

机构地区：[1]黄山市人民医院全科医学科,安徽黄山245000

出　　处：《临床和实验医学杂志》2023年第18期1925-1929,共5页Journal of Clinical and Experimental Medicine

基　　金：安徽省卫生健康委科研项目(编号:AHWJ2021b103)。

摘　　要：目的探究外周血血小板淋巴细胞比值(PLR)、低密度脂蛋白(LDL)、同型半胱氨酸(Hcy)水平与老年高血压患者颈动脉斑块形成及稳定性的关系。方法选取2019年10月至2022年10月黄山市人民医院收治的80例老年高血压患者纳入本研究,分析患者的临床资料,根据患者颈动脉斑块的有无将患者分为斑块组(n=58)和无斑块组(n=22),检测患者外周血PLR、LDL、Hcy水平,探究其与患者颈动脉斑块形成的关系及对患者斑块形成的预测价值。对斑块组患者进行分析,根据患者斑块是否稳定将其分为斑块稳定组(n=21)和斑块不稳定组(n=37),比较两组间患者外周血PLR、LDL、Hcy水平,探究其与患者颈动脉斑块稳定性间的关系及预测价值。结果斑块组患者年龄、体重指数、冠心病史患者比率、糖尿病史患者比率、病程、PLR、LDL及Hcy水平均高于无斑块组,差异均有统计学意义(P<0.05)。PLR、LDL、Hcy、体重指数、病程等因素均为高血压患者颈动脉斑块形成的影响因素(P<0.05)。作血清PLR、LDL、Hcy水平预测高血压患者颈动脉斑块形成的预测价值曲线,其曲线下面积(AUC)值分别为0.797、0.751、0.773。斑块稳定组的年龄、体重指数、病程均高于斑块不稳定组,糖尿病史患者比率、PLR、总胆固醇、LDL及Hcy水平均低于斑块不稳定组,差异均有统计学意义(P<0.05)。PLR、LDL、Hcy、体重指数、病程等因素均为高血压患者颈动脉斑块形成的影响因素(P<0.05)。作血清PLR、LDL、Hcy水平预测高血压患者颈动脉斑块不稳定的预测价值曲线,其AUC值分别为0.933、0.934、0.996。结论外周血PLR、LDL、Hcy水平与老年高血压患者颈动脉斑块形成及稳定性关系密切,其是老年高血压患者颈动脉斑块形成、不稳定的影响因素,且对斑块形成及斑块不稳定具有一定的预测价值。Objective To explore the relationship between peripheral blood platelet lymphocyte ratio(PLR),low density lipoprotein(LDL),homocysteine(Hcy)level and plaque formation and stability of carotid artery in elderly hypertensive patients.Methods Eighty elderly hypertensive patients admitted to Huangshan People's Hospital from October 2019 to October 2022 were included in the study,the clinical data of the patients were analyzed,and they patients were divided into a plaque group(n=58)and a no-plaque group(n=22)according to the presence or absence of the carotid plate,PLR,LDL,Hcy levels of patients were detected,its correlation with the plaque formation of the carotid artery and the predictive value of the plaque formation of the patients were explored;for the analysis of the patients in the plaque group,the patients were divided into plaque stable group(n=21)and plaque unstable group(n=37),PLR,LDL,Hcy levels in peripheral blood between the two groups were compared,the correlation and predictive value of them with the stability of carotid plaque were explored.Results Age,body mass index,ratio of patients with coronary heart disease history,ratio of patients with diabetes history,course of disease,PLR,LDL and Hcy levels in plaque group were significantly higher than those in plaque free group,the differences were statistically significant(P<0.05).PLR,LDL,Hcy,body mass index,and course of disease are all influencing factors for the formation of carotid artery plaques in hypertensive patients(P<0.05).The predictive value curve of serum PLR,LDL,and Hcy levels for predicting carotid plaque formation in hypertensive patients was plotted,the area under the cure(AUC)values were 0.797,0.669,and 0.773,respectively.The age,body mass index and course of disease in the plaque stable group were higher than those in the plaque unstable group,and the ratio of patients with diabetes history,PLR,total cholesterol,LDL and Hcy levels were lower than those in the plaque unstable group,the differences were statistically significant(P<0.05).PL

关 键 词：高血压 老年人 血小板淋巴细胞比值 低密度脂蛋白 同型半胱氨酸 颈动脉斑块 稳定性 

分 类 号：R544.1[医药卫生—心血管疾病]