NHR、MHR、WHR在急性冠脉病变中的潜在预测价值  

Potential Predictive Value of NHR,MHR and WHR in Acute Coronary Artery Disease

作　　者：卯骏聪 洪云飞 魏引 蔡叶锐 尹劲松 Mao Juncong;Hong Yunfei;Wei Yin;Cai Yerui;Yin Jinsong(Department of Cardiology,The Third People's Hospital of Yunnan Province,Kunming 650000,China)

机构地区：[1]云南省第三人民医院心内科,昆明650000

出　　处：《大理大学学报》2025年第4期56-64,共9页Journal of Dali University

基　　金：云南省地方本科高校基础研究联合专项资金项目(202001BA07001-088);云南省教育厅科学研究基金项目(2020J0622)。

摘　　要：目的:探讨单核细胞/高密度脂蛋白胆固醇比值(MHR)、中性粒细胞/高密度脂蛋白胆固醇比值(NHR)及白细胞/高密度脂蛋白胆固醇比值(WHR)对急性冠脉综合征(ACS)患者的发病风险及冠脉病变程度的预测效能。方法:选取2023年1月—2024年1月在云南省第三人民医院接受急诊经皮冠脉介入术治疗的ACS患者130例为研究对象,纳入病例组,另选取同期在医院内行冠脉造影检查且排除ACS的患者80例作为对照组。依据Gensini评分,将ACS患者分为高分组(Gensini评分≥48分,66例)和低分组(Gensini评分<48分,64例),比较组间基线资料及实验室资料差异,并采用相关统计学分析NHR、MHR及WHR与ACS严重性的相关性。结果:病例组与对照组在MHR、NHR和WHR指标上存在显著差异,这3项指标与冠脉病变程度的Gensini评分呈显著正相关。多因素Logistic回归分析进一步揭示NHR是预测冠脉病变严重程度的独立因素。ROC曲线分析显示,NHR具有较高的预测价值,其曲线下面积达0.673,且NHR≥3.8625被确定为识别ACS患者冠脉病变严重程度的最佳临界值。结论:NHR作为冠脉病变严重程度的独立危险因素,与Gensini评分呈显著正相关,且预测价值较高,NHR水平越高表明冠脉病变程度越重,是评估ACS患者冠脉病变严重程度的重要生物标志物。Objective:To investigate the predictive efficacy of monocyte to high-density lipoprotein cholesterol ratio(MHR),neutrophil to high-density lipoprotein cholesterol ratio(NHR),and white blood cell to high-density lipoprotein cholesterol ratio(WHR)on the onset risk and the severity of coronary artery disease in patients with acute coronary syndrome(ACS).Methods:A total of 130 patients with ACS who received emergency percutaneous coronary intervention in the Third People's Hospital of Yunnan Province from January 2023 to January 2024 were selected as the study objects and included into the case group,another 80 patients who received coronary angiography in the hospital during the same period and excluded ACS were selected as the control group.According to the Gensini score,ACS patients were divided into a high lesion group(Gensini score≥48,66 cases)and a low lesion group(Gensini score<48,64 cases).Differences in baseline and experimental data between the groups were compared,and relevant statistical analyses were used to analyze the correlation between NHR,MHR,WHR,and the severity of ACS.Results:Significant differences in MHR,NHR,and WHR were observed between the case group and the control group.These three indicators were positively correlated with the Gensini score of the severity of coronary artery disease.Multivariate Logistic regression analysis further revealed that NHR was an independent predictor of the severity of coronary artery disease.ROC curve analysis showed that NHR had high predictive value,with an area under the curve of 0.673.NHR≥3.8625 was identified as the optimal cutoff value for assessing the severity of coronary artery disease in patients with ACS.Conclusion:NHR serves as an independent risk factor for coronary artery disease severity,showing a significant positive correlation with the Gensini score.With a high predictive value,a higher NHR level indicates a more severe coronary lesion,making it an important biomarker for assessing the severity of coronary artery disease in ACS patients.

关 键 词：急性冠脉综合征 单核细胞/高密度脂蛋白胆固醇比值 白细胞/高密度脂蛋白胆固醇比值 中性粒细胞/高密度脂蛋白胆固醇比值 GENSINI评分 

分 类 号：R541.4[医药卫生—心血管疾病]