冠状动脉慢血流患者MHR和SII水平变化及诊断意义  

Changes of MHR and SII levels in patients with coronary slow flow and their diagnostic significance

作　　者：房志琴 马逸平 梁惠清[1] 李珺 赵坤 张鹏祥[1] 王亚玲[1] 李方江[1] 李萍萍 FANG Zhiqin;MA Yiping;LIANG Huiqing;LI Jun;ZHAO Kun;ZHANG Pengxiang;WANG Yaling;LI Fangjiang;LI Pingping(Department of Cardiology,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China;Department of Reproductive Medicine,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China;Department of Ultrasound Medicine,the First Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China)

机构地区：[1]河北北方学院附属第一医院心内科,河北张家口075000 [2]河北北方学院附属第一医院生殖医学科,河北张家口075000 [3]河北北方学院附属第一医院超声科,河北张家口075000

出　　处：《中国分子心脏病学杂志》2025年第1期6602-6607,共6页Molecular Cardiology of China

基　　金：河北省省级科技计划科技冬奥专项(20477708D);河北省卫生健康委医学科学研究课题计划(20200528)。

摘　　要：目的探讨冠状动脉慢血流(coronary slow flow,CSF)患者和冠状动脉血流正常(normal coronary flow,NCF)患者中单核细胞/高密度脂蛋白胆固醇比(monocyte/high-density lipoprotein cholesterol ratio,MHR)和全身免疫炎症指标(systemic immune inflammation index,SII)水平的差异,明确MHR和SII对CSF患者诊断的预测价值。方法随机选取2023年1月至2024年3月因胸痛或胸闷症状于河北北方学院附属第一医院心内科行冠状动脉造影的患者,CSF组40例,NCF组40例。比较两组患者病史及化验指标等基本临床资料。采用二元logistic回归分析研究MHR、SII与CSF患病的关系,采用Pearson相关分析研究MHR、SII与平均心肌梗死溶栓后血流计帧数(mean thrombolysis in myocardial infarction frame count,mTFC)相关性,利用受试者操作特征(receiver operating characteristic,ROC)曲线评估MHR、SII及两者联合对CSF的预测价值。结果与NCF组相比,CSF组MHR[(3.80±1.79)×10^(8)/mmol比(1.28±0.80)×10^(8)/mmol]、SII[(411.6±15.2)×10^(9)/L比(392.7±13.7)×10^(9)/L]及mTFC[(48.03±5.03)帧比(25.83±6.32)帧]均升高(P均<0.05)。Logistic多因素分析提示MHR和SII均为CSF的独立危险因素(OR=4.201,95%CI:1.749~10.092,P=0.001;OR=1.089,95%CI:1.024~1.158,P=0.007)。MHR、SII均与mTFC显著正相关(r=0.407,r=0.445,P均<0.05)。MHR预测CSF的ROC曲线下面积(area under the curve,AUC)为0.901(P<0.001),灵敏度为82.5%,特异度为90.0%,95%CI为0.833~0.969;SII预测CSF的AUC为0.844(P<0.001),灵敏度为82.5%,特异度为77.5%,95%CI为0.757~0.932;两者联合诊断CSF的AUC为0.932(P<0.001),灵敏度为87.5%,特异度为95.0%,95%CI为0.875~0.990。结论与NCF组相比,CSF组MHR和SII水平显著升高,MHR、SII及二者联合对冠状动脉慢血流有较好的预测价值。Objective To investigate the differences in the levels of the monocyte/high-density lipoprotein cholesterol ratio(MHR)and systemic immune inflammation index(SII)between patients with coronary slow flow(CSF)and those with normal coronary flow(NCF),and to study the predictive value of MHR and SII for the diagnosis of patients with CSF.Methods From January 2023 to March 2024,40 patients in the CSF group and 40 patients in the normal coronary flow(NCF)group were enrolled in the department of cardiology of the First Affiliated Hospital of Hebei North University for coronary angiography due to chest pain or chest distress.The basic clinical data of the two groups were compared.Binary Logistic regression analysis was used to analyze the correlation between MHR,SII and CSF.The correlation between MHR,SII and mean thrombolysis in myocardial infarction frame count(mTFC)were analyzed by Pearson correlation,and receiver operator characteristic(ROC)curve was used to evaluate the predictive value of MHR,SII and their combination for CSF.Results Compared to the NCF group,the level of MHR[(3.80±1.79)×10^(8)/mmol vs.(1.28±0.80)×10^(8)/mmol],SII[(411.6±15.2)×10^(9)/L vs.(392.7±13.7)×10^(9)/L]and mTFC[(48.03±5.03)framesvs.(25.83±6.32)frames]in the CSF group were increased(P<0.05).Logistic multivariate analysis showed thatboth MHR and SII were independent risk factors for CSF(OR=4.201,95%CI:1.749-10.092,P=0.001;OR=1.089,95%CI=1.024-1.158,P=0.007).MHR and SII were significantly positively correlated with mTFC(r=0.407,r=0.445,P<0.05).MHR predicted that the area under ROC curve(AUC)of CSF was 0.901(P<0.001),the sensitivity was 0.825,the specificity was0.9,and 95%CIwas 0.833-0.969.The AUC predicted by SII was 0.844(P<0.001),the sensitivity was 0.825,the specificitywas 0.775,and 95%CIwas 0.757-0.932.The AUC for the combined diagnosis of CSF was 0.932(P<0.001),the sensitivity was0.875,the specificity was 0.95,and 95%CIwas 0.875-0.990.Conclusions Compared with the control group,the levels of MHRand SII in CSF group increase signi

关 键 词：冠状动脉慢血流 单核细胞/高密度脂蛋白胆固醇比值 全身免疫炎症指标 诊断价值 

分 类 号：R541.4[医药卫生—心血管疾病]