单核细胞/高密度脂蛋白胆固醇比值与原发性高血压患者发生左心房增大的关系  

The correlation between monocyte to high-density lipoprotein cholesterol ratio and left atrial enlargement in patients with essential hypertension

作　　者：马庆华 孟翠巧[2] 李刚[3] MA Qinghua;MENG Cuiqiao;LI Gang(Graduate School of North China University of Science and Technology,Tangshan 063000,China;Department of Medical Eramination Center,Hebei General Hospital;Department of Geriatric Cardiology,Hebei General Hospital)

机构地区：[1]华北理工大学研究生学院,河北唐山063000 [2]河北省人民医院体检中心 [3]河北省人民医院老年心血管科

出　　处：《中华高血压杂志（中英文）》2024年第11期1043-1048,共6页Chinese Journal of Hypertension

基　　金：河北省自然科学基金(H2023307028)。

摘　　要：目的探讨单核细胞/高密度脂蛋白胆固醇比值(MHR)与原发性高血压(EH)患者左心房增大(LAE)的相关性,建立个体化列线图预测模型。方法收集2022年8月至2023年9月经河北省人民医院确诊的原发性高血压患者889例,建立回顾性数据库。根据经胸超声心动图(TTE)检查结果,将患者分为LAE组(n=168)和无LAE组(n=721)。采用多因素logistic回归分析确认EH患者发生LAE的风险因素。基于得到的危险因素构建列线图模型,并绘制受试者操作特征(ROC)曲线、校准曲线对模型进行验证。结果与无LAE组相比,LAE组患者年龄、体重指数、收缩压、脉压、白细胞计数、中性粒细胞计数、单核细胞、甘油三酯、低密度脂蛋白胆固醇、左心室舒张末期内径较高(均P<0.05),LAE患者MHR高于无LAE患者[0.28(0.23,0.36)比0.22(0.17,0.29),Z=-7.467,P<0.001]。多因素logistic回归分析结果显示:性别、年龄、体重指数、脉压、甘油三酯、高密度脂蛋白胆固醇、左心室舒张末期内径与MHR是EH患者存在LAE的危险因素。构建的列线图模型ROC曲线下面积(AUC)为0.924,绘制校准曲线显示,模型的一致性指数(C-index)为0.925,曲线斜率=1,表明此模型效能较好。结论MHR为EH患者发生LAE的风险因素。Objective To investigate the correlation between monocyte to high-density lipoprotein cholesterol ratio(MHR)and left atrial enlargement(LAE)in patients with essential hypertension(EH).To establish an individualized nomogram prediction model.Methods The clinical data of 889 patients with EH diagnosed in Hebei General Hospital from August 2022 to September 2023 were collected and a retrospective database was established.According to the results of transthoracic echocardiography(TTE),the patients were divided into LAE group(n=168)and non-LAE group(n=721).Multivariate logistic regression analysis was used to analyse the risk factors of LAE in EH patients.Based on the obtained risk factors,a nomogram model was constructed,and the receiver operating characteristic(ROC)curveand calibration curve were drawn to verify the model.Results Compared with the non-LAE group,the age,body mass index,systolic blood pressure,pulse pressure,white blood cell count,neutrophil count,monocytes,triglyceride(TG),low-density lipoprotein cholesterol(LDL-C)and left ventricular end-diastolic diameter(LVEDD)were higher in the LAE group(all P<0.05).MHR in LAE group was higher than that in non-LAE group[0.28(0.23,0.36)vs 0.22(0.17,0.29),Z=-7.467,P<0.001].Multivariate logistic regression analysis showed that gender,age,body mass index,pulse pressure,TG,high-density lipoprotein cholesterol(HDL-C),LVEDD and MHR were risk factors for LAE in EH patients.The area under the ROC curve(AUC)of the constructed nomogram model was 0.924.The calibration curve showed that the consistency index(C-index)of the model was 0.925,and the slope of the curve was 1,indicating that the model had good performance.Conclusion MHR is correlated with LAE in patients with EH.

关 键 词：原发性高血压 单核细胞/高密度脂蛋白胆固醇比值 左心房扩大 列线图 

分 类 号：R544.11[医药卫生—心血管疾病]