NPAR、RC与急性冠脉综合征病变严重程度的相关性分析  

Correlation analysis of NPAR,RC and severity of acute coronary syndrome

作　　者：李军 杨阳[1] 乐兴丁[1] 王传辉[1] 张世袍[1] LI Jun;YANG Yang;LE Xingding;WANG Chuanhui;ZHANG Shipao(Sanming Second Hospital,Yong'an 366000,China)

机构地区：[1]三明市第二医院,福建永安366000

出　　处：《延边大学医学学报》2024年第4期382-386,共5页Journal of Medical Science Yanbian University

摘　　要：目的:观察急性冠脉综合征(ACS)患者残粒胆固醇(RC)、中性粒细胞百分比/白蛋白(NPAR)比值变化,分析其水平与ACS患者病情严重程度的相关性。方法:纳入2020年8月至2023年8月三明市第二医院胸痛中心收治的ACS患者160例作为观察组(ACS组),同期因胸痛入住心内科经冠状动脉造影排除冠心病患者160例为对照组。对比两组RC、NPAR的差异。同时根据Gensini评分将ACS患者分成轻度狭窄组(n=43)、中度狭窄组(n=64)、重度狭窄组(n=53),对比各组NPAR、RC的差异。采用单因素相关分析NPAR、RC与Gensini评分的相关性。采用Logistic回归分析冠脉狭窄程度的影响因素,采用ROC曲线分析NPAR、RC对冠脉狭窄程度的诊断效能。结果:ACS组收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、NPAR、RC、同型半胱氨酸(Hcy)均较对照组升高,而高密度脂蛋白胆固醇(HDL-C)较对照组降低(P<0.01)。随着Gensini评分的升高,ACS患者RC、NPAR水平均逐渐升高(P<0.01)。Pearson相关分析,NPAR(r=0.688)、RC(r=0.731)水平与Gensini评分均呈正相关。Logistic回归分析,SBP、DBP、TG、LDL-C、RC、NPAR、FBG、Hcy均为冠脉狭窄程度独立危险因素,HDL-C为冠脉狭窄程度保护性因素。ROC曲线分析,NPAR、RC预测ACS患者冠脉狭窄程度曲线下面积分别为0.774、0.814,两者联合检测曲线下面积为0.886,明显高于NPAR、RC单独检测(P<0.01)。结论:ACS患者NPAR、RC水平均明显升高,其水平与冠状动脉狭窄程度呈正相关,两者联合可显著提高对ACS患者冠状动脉狭窄程度的预测价值。Objective:To observe the changes of residual cholesterol(RC)and neutrophil percentage/albumin ratio(NPAR)in patients with acute coronary syndrome(ACS)and analyze the correlation between their levels and the severity of ACS.Methods:A total of 160 ACS patients admitted to the Chest Pain Center of Sanming Second Hospital from August 2020 to August 2023 were enrolled as the observation group(ACS group).Simultaneously,160 patients who were admitted to the cardiology department due to chest pain and excluded from coronary heart disease by coronary angiography were enrolled as the control group.The differences in RC and NPAR between the two groups were compared.At the same time,ACS patients were divided into mild stenosis group(n=43),moderate stenosis group(n=64)and severe stenosis group(n=53)according to the Gensini score,and the differences in NPAR and RC among these groups were compared.A univariate correlation analysis was conducted to analyze the correlation between NPAR,RC and the Gensini score.Logistic regression was used to analyze the influencing factors of the degree of stenosis of coronary artery lesions,and ROC curve was used to analyze the diagnostic efficacy of NPAR and RC on the degree of stenosis of coronary artery lesions.Results:Systolic blood pressure(SBP),diastolic blood pressure(DBP),triglycerides(TG),low density lipoprotein cholesterol(LDLC),fasting blood glucose(FBG),NPAR,RC,and homocysteine(Hcy)in ACS group were higher than those in the control group,while high density lipoprotein cholesterol(HDLC)was lower was lower than that in the control group(P<0.01).With the increase of Gensini score,the levels of RC and NPAR in ACS patients were gradually increased(P<0.01).Pearson correlation analysis showed that the levels of NPAR(r=0.688)and RC(r=0.731)were positively correlated with the Gensini score.Logistic regression analysis indicated that SBP,DBP,TG,LDLC,RC,NPAR,FBG and Hcy were all independent risk factors for the severity of coronary artery lesions stenosis,while HDLC was a protective factor.ROC

关 键 词：急性冠脉综合征 残粒胆固醇 中性粒细胞百分比 白蛋白 冠状动脉狭窄程度 

分 类 号：R543.3[医药卫生—心血管疾病]