炎性细胞在冠状动脉粥样硬化性心脏病中的作用及临床意义

The role and clinical significance of inflammatory cells in patients with coronary heart disease

目的探讨不同炎性细胞的变化在冠状动脉粥样硬化性心脏病(冠心病)中的意义。方法经冠状动脉造影确诊的冠心病患者(100例)分为急性冠状动脉综合征(ACS)组(50例)和稳定型心绞痛(SAP)组(50例),并设50例冠状动脉造影正常者为对照组(非冠心病组),检测各组外周血白细胞计数、各种白细胞比例、中性粒细胞比例/淋巴细胞比例的变化。结果冠心病组患者的白细胞计数、中性粒细胞比例、中性粒细胞比例/淋巴细胞比例均高于非冠心病组,差异均有统计学意义(P<0.05)。ACS组白细胞计数、中性粒细胞比例、单核细胞比例和中性粒细胞比例/淋巴细胞比例高于非冠心病组,差异有统计学意义(P<0.05);ACS组淋巴细胞比例低于非冠心病组,差异有统计学意义(P<0.05);且ACS组白细胞计数明显高于SAP组,差异有统计学意义(P<0.01)。冠心病组中3支血管病变组白细胞计数和中性粒细胞比例/淋巴细胞比例高于2支病变组,差异有统计学意义(P<0.05);3支血管病变组白细胞计数和单核细胞比例高于1支病变组,差异有统计学意义(P<0.05);3支血管病变组白细胞计数、中性粒细胞比例、单核细胞比例和中性粒细胞比例/淋巴细胞比例高于非冠心病组,淋巴细胞比例低于非冠心病组,差异均有统计学意义(P<0.05)。结论不同炎性细胞的变化在冠心病中有不同的意义,中性粒细胞、单核细胞的升高和淋巴细胞的降低,能反映冠状动脉病变程度和急性病变的情况。同时,在评价冠心病炎症情况时,中性粒细胞比例/淋巴细胞比例可能是一个具有重要意义的指标。

Objective To study the relationship between different kinds of leukocytes and coronary heart disease （CHD）. Methods Under coronary angiography, 100 patients were divided into 2 groups： group including 50 cases of acute coronary syndrome（ ACS group） patients and group including 50 cases of stable angina pectoris （ SAP group） patients. Fifity patients who had normal coronary artery were chosen as control group. The peripheral leukocyte count, the proportion of different kinds of leukocytes and neutrophil/lymphocyte ratio were detected. Results The leukocyte count, the proportion of neutrophil and neutrophil/lymphocyte ratio were higher in CHD group than control group （ P 〈 0. 05 ）. The leukocyte count, the proportions of neutrophil and monocyte, neutrophil/lymphocyte ratio were higher in ACS group than control group （P 〈 0.05 ）. The proportion of lymphocyte was lower in ACS group than control group（P 〈 0. 05 ）. The leukocyte count was higher in ACS group than SAP group （P 〈 0. 01 ）. At the same time, the leukocyte count and neutrophil/lymphocyte ratio were higher in the group under three branches arteies stenosis than the group under two branches arteies stenosis and control group （P 〈 0. 05）. The leukocyte count and the proportion of monocyte were higher in the group under three branches arteies stenosis than the group under one branches arteies stenosis and control group（P 〈 0. 05）. The leukocyte count, the proportions of neutrophil and monocyte, neutrophil/lymphocyte ratio were higher in the group under three branches arteies stenosis than control group（P 〈 0. 05 ）. The proportion of lymphocyte was lower in the group under three branches arteies stenosis than control group （P 〈 0. 05 ）. Conclusion It was suggested that there is correlation between the leukocyte and CHD. The elevated neutrophil and monocyte level, lower lymphocyte level play an important role in the progression and pathogenesis of CHD. At the same time, the neutrophil/lymphocyte ratio was an important predictor of cardiovascular inflammation.