白细胞计数和中性粒/淋巴比值与冠心病斑块负荷的关系研究

Relationship of white blood cell count and neutrophil /lymphocyte ratio with the severity of coronary atherosclerotic plaque burden

目的：探讨冠心病患者外周血白细胞计数和中性粒细胞与淋巴细胞比值（ N/L）与冠心病斑块负荷的关系。方法选取2011年3月-2012年2月住院175例冠心病患者（心肌梗死69例、不稳定型心绞痛64例，稳定型心绞痛42例）为冠心病组，同期住院无冠心病82例患者为对照组。用Sysmex SF-3000全自动五分类血细胞分析仪，计数并分类检测白细胞计数及白细胞分类比例，并计算N/L比值。采集患者的临床资料，对行冠脉造影的患者采用Gensini积分法对冠心病患者主要冠状动脉狭窄程度定量评估， Sullivan法评价冠状动脉粥样硬化斑块负荷。结果冠心病组患者的白细胞计数、N/L比值均高于正常对照组（P＜0．01）；AMI组白细胞计数、N/L比值均高于SAP组、UAP组（P＜0．05）；UAP组白细胞计数、N/L值均高于SAP组（P＜0．05）。白细胞计数与Gensini积分呈正相关（r＝0．226，P＜0．05）；白细胞计数和N/L比值与CAPB积分呈正相关（r＝0．354，P＜0．05；r＝0．435， P＜0．01）。在考虑了相关因素后，进一步行多元逐步回归分析，白细胞计数和N/L比值是斑块负荷的独立预测因素（OR＝0．12，95％CI 0．03～0．23，P＜0．01），但对血管狭窄程度无此作用（P＝0．067）。结论外周血白细胞计数和N/L比值可以反映冠心病斑块负荷的严重程度。

Objective To investigate the relationship of white blood cell count and neutrophil /lymphocyte （N/L） ratio with the severity of coronary atherosclerotic plaque burden （CAPB）.Methods From March 2011 to February 2012, 175 hospitalized patients with coronary artery disease [69 cases of myocardial infarction （AMI）, 64 cases of unstable angina （ UAP） , 42 cases of stable angina （ SAP） ] , and 82 healthy controls were enrolled in the study .Sysmex SF-3000 auto-matic hematology analyzer was used for white cell count and classification , and calculation of N/L ratio.Clinical data were collected.Coronary angiography was used for quantitative assessment on coronary artery stenosis through Gensini scoring method and on coronary atherosclerotic plaque burden through Sullivan method in the coronary artery disease patients .Re-sults White blood cell count and N/L ratio in the coronary artery disease patients were higher than those in the healthy con -trols （P〈0.01）.White blood cell count and N/L ratio in AMI group were higher than those in SAP group and UAP group （P〈0.05）.Compared to SAP group, UAP group had higher white blood cell count and N/L ratio （〈0.05）.White blood cell count was positively correlated with Gensini scores （r=0.226, P〈0.05）.Both white blood cell count （r=0.354, P〈0.05） and N/L ratio （r=0.435, P＆lt;0.01） were positively correlated with CAPB.Multiple stepwise regres-sion analysis indicated white blood cell count and N /L ratio were independent predictors for CAPB （ Or=0.12, 95% CI 0.03-0.23, P〈0.01）, but were not correlated with blood vessels stenosis （P=0.067）.Conclusion White blood cell count and N/L ratio may reflect severity of coronary plaque burden .