非ST段抬高型急性冠脉综合征患者NHR与冠脉病变严重程度的相关性  

Correlation between neutrophil to high-density lipoprotein cholesterol ratio and severity of coronary artery disease in patients with non-ST segment elevation acute coronary syndrome

作　　者：周娜[1,2] 王萌 刘兆平 陈晨[1,2] 章蓓蓓 杨辉[1,2] 汪哲 范彬 陈永恒[1,2] 何静 钱倩倩[1,2] 倪延硕 程自平 ZHOU Na;WANG Meng;LIU Zhaoping;CHEN Chen;ZHANG Beibei;YANG Hui;WANG Zhe;FAN Bin;CHEN Yongheng;HE Jing;QIAN Qianqian;NI Yanshuo;CHENG Ziping(Department of Cardiology,The First Affiliated Hospital of Anhui Medical University,Hefei 230012,China;Anhui Public Health Clinical Center,Hefei 230012,China;Department of Cardiology,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第一附属医院心血管内科,安徽合肥230012 [2]安徽省公共卫生临床中心,安徽合肥230012 [3]安徽医科大学第二附属医院心血管内科,安徽合肥230601

出　　处：《西部医学》2023年第11期1625-1631,共7页Medical Journal of West China

基　　金：安徽省高校自然科学研究重点项目(2022AH050658);安徽医科大学第二附属医院临床研究培育计划项目(2021LCYB19)。

摘　　要：目的 探讨中性粒细胞/高密度脂蛋白胆固醇比值(NHR)与非ST段抬高型急性冠脉综合征(NSTE-ACS)患者冠脉病变严重程度的相关性。方法 回顾性连续纳入2018年8月—2022年4月在安徽医科大学第一附属医院北区行冠脉造影检查的168例NSTE-ACS的患者。以Gensini积分和冠脉病变血管支数为NSTE-ACS患者冠脉病变严重程度的评估标准。依据Gensini积分,将NSTE-ACS患者分为低分组(<45分,n=89)和高分组(≥45分,n=79)。依据冠脉病变血管支数,将NSTE-ACS患者分为冠脉单双支血管病变组(n=87)和冠脉三支及以上血管病变组(n=81)。比较各组间临床资料,采用多因素二元Logistic回归分析NSTE-ACS患者Gensini积分高分组、冠脉三支及以上血管病变组的独立影响因素。应用受试者工作特征(ROC)曲线探讨NHR对NSTE-ACS患者冠脉病变严重程度的预测价值。结果 Gensini高分组、冠脉三支及以上血管病变组NHR显著升高(P<0.05)。多因素二元Logistic回归分析提示,NHR是NSTE-ACS患者Gensini高分和冠脉三支及以上血管病变的独立影响因素(OR=1.702,95%CI:1.135~2.551,P=0.010;OR=1.312,95%CI:1.020~1.688,P=0.034)。ROC曲线结果显示,NHR预测NSTE-ACS患者Gensini高分的曲线下面积为0.668,最佳截断值为6.043,灵敏度为37.2%,特异度为89.9%;NHR预测NSTE-ACS患者冠脉三支及以上血管病变的曲线下面积为0.658,最佳截断值为4.334,灵敏度为65%,特异度为62.1%。结论 NHR是NSTE-ACS冠状动脉病变严重程度的独立影响因素,对NSTE-ACS患者冠状动脉病变严重程度具有预测价值。Objective To explore the correlation of neutrophil to high-density lipoprotein cholesterol ratio(NHR)with the severity of coronary artery disease in patients attacked by non-ST segment elevation acute coronary syndrome(NSTE-ACS).Methods A total of 168 consecutive patients with NSTE-ACS undergoing coronary angiography in North District of The First Affiliated Hospital of Anhui Medical University from August 2018 to April 2022 were enrolled for the retrospective study.The evaluation for the severity of coronary artery lesions in patients with NSTE-ACS was carried out taking Gensini score and the number of coronary artery lesions as reference.The enrolled patients were divided into low group(Gensini score<45,n=89)and high group(Gensini score≥45,n=79)based on the Gensini score,then into single-vessel and double-vessel coronary artery disease group(n=87)and three-vessel or more coronary artery disease group(n=81)according to the number of diseased coronary vessels.Clinical data between groups were compared.Multivariate binary logistic regression was performed to identify the independent risk factors of high Gensini score group and three-vessel or more coronary artery disease group in NSTE-ACS patients.Receiver operating characteristic(ROC)curve was plotted for assessing the predictive value of NHR on the severity of coronary artery disease in NSTE-ACS patients.Results The significantly increased NHR was displayed in Gensini high group and three-vessel or more coronary artery disease group(P<0.05).The results of multivariate binary logistic regression analysis indicated NHR as an independent risk factor driving high Gensini score and three or more coronary vessel lesions in patients with NSTE-ACS(OR=1.702,95%CI:1.135~2.551,P=0.010;OR=1.312,95%CI:1.020~1.688,P=0.034).The area under the ROC curve of NHR predicting high Gensini score in NSTE-ACS patients was 0.668,with the best cut-off value of 6.043,the sensitivity of 37.2%,and the specificity of 89.9%.The area under the curve of NHR predicting the lesion of three or m

关 键 词：中性粒细胞 高密度脂蛋白胆固醇 冠状动脉病变 非ST段抬高型急性冠脉综合征 

分 类 号：R543.3[医药卫生—心血管疾病]