THR、MHR和NHR对冠状动脉狭窄程度和行PCI的预测价值  

Predictive value of THR,MHR and NHR combined in assessing coronary artery stenosis severity and percutaneous coronary intervention

作　　者：刘成[1] 刘森 杨红[1] 金梦龙 刘紫阳 付真彦[1] 马依彤[1] LIU Cheng;LIU Sen;YANG Hong;JIN Menglong;LIU Ziyang;FU Zhenyan;MA Yitong(DepartmentⅡof Coronary Heart Disease,Heart Center,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学第一附属医院心脏中心冠心病二科,新疆乌鲁木齐830000

出　　处：《西安交通大学学报（医学版）》2024年第6期948-953,共6页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：新疆维吾尔自治区重点研发计划项目(No.2022B03022,No.2022B03022-4)。

摘　　要：目的 探讨总胆固醇与高密度脂蛋白胆固醇比值(THR)、单核细胞与高密度脂蛋白胆固醇比值(MHR)和中性粒细胞与高密度脂蛋白胆固醇比值(NHR)对患者冠状动脉狭窄程度和行经皮冠状动脉介入(PCI)治疗的预测价值。方法 回顾性选取2021年6月至2023年6月在新疆医科大学第一附属医院行冠状动脉造影的患者,严格纳入排除标准筛选,共纳入6 281例患者,分为PCI组和non-PCI组,收集所有患者的临床资料、实验室检查结果及介入治疗资料。采用Pearson相关性分析评估THR、MHR和NHR与冠状动脉狭窄程度之间的关联。使用二元Logistic逐步回归和受试者工作特征(ROC)曲线评估THR、MHR和NHR单一指标和联合指标对冠心病患者行PCI治疗的影响因素和预测价值。结果 与Non-PCI组比较,PCI组年龄偏大,男性占比、患糖尿病占比、THR、MHR、NHR、Gensini评分高于Non-PCI组,既往支架植入比例少于Non-PCI组(P<0.05)。Pearson相关分析结果显示,THR(r=0.351,P<0.001)、MHR(r=0.192,P<0.001)和NHR(r=0.236,P<0.001)水平与冠状动脉狭窄程度的Gensini评分均存在显著正相关关系。多因素Logistic回归结果显示,年龄>50岁、男性、患糖尿病、THR、MHR、NHR是冠心病患者行PCI独立危险因素,既往支架植入史是冠心病患者行PCI的保护因素。ROC曲线结果显示,THR、MHR和NHR三者联合曲线下面积(AUC)最大(AUC=0.809,95%CI:0.798~0.820)。结论 THR、MHR和NHR与冠状动脉狭窄程度具有相关性,对评估冠心病行PCI治疗有较强的临床应用价值。Objective To investigate the value of total cholesterol to high-density lipoprotein cholesterol ratio(THR),monocyte to high-density lipoprotein cholesterol ratio(MHR),and neutrophil to high-density lipoprotein cholesterol ratio(NHR)in predicting patients’coronary artery stenosis severity and percutaneous coronary intervention(PCI).Methods A total of 6281 patients who underwent coronary angiography at our hospital between June 2021 and June 2023 were retrospectively included in this study.These patients were divided into two groups:PCI group and non-PCI group.The clinical data,laboratory findings,and interventional treatment data of all patients were collected and analyzed.Pearson correlation analysis was employed to evaluate the correlation of THR,MHR and NHR with the degree of coronary artery stenosis.Binary Logistic stepwise regression and receiver operating characteristic(ROC)curve were utilized to assess the influencing factors and predictive value of THR,MHR and NHR single and combined indexes for coronary artery disease patients undergoing PCI.Results The PCI group was observed to be older,with a higher proportion of males,individuals with diabetes mellitus,and those who had undergone THR,MHR,NHR,and a Gensini score than the non-PCI group.Conversely,the proportion of previous stent implantation was less than that of the non-PCI group(P<0.05).The results of Pearson correlation analysis showed a significant and positive correlation of the Gensini score with THR(r=0.351,P<0.001),MHR(r=0.192,P<0.001),and NHR(r=0.236,P<0.001)levels,indicating that these variables had a significantly positive correlation with the degree of coronary artery stenosis.The results of multifactorial Logistic regression demonstrated that age>50 years,male sex,diabetes mellitus,THR,MHR,and NHR were independent risk factors for PCI in patients with coronary artery disease.Conversely,a history of previous stent implantation was identified as a protective factor for PCI in patients with coronary artery disease.Furthermore,the results of R

关 键 词：总胆固醇与高密度脂蛋白胆固醇比值(THR) 单核细胞与高密度脂蛋白胆固醇比值(MHR) 中性粒细胞与高密度脂蛋白胆固醇比值(NHR) 冠状动脉狭窄 经皮冠状动脉介入治疗(PCI) 

分 类 号：R540.44[医药卫生—心血管疾病]