冠心病患者血液学指数和心肌血流储备分数的相关性

Association of haematological indices with fractional flow reserve in patients with coronary artery disease

目的评估冠心病患者血液学指数与心肌血流储备分数（FFR）的相关性。方法纳入177例患者共267处病变,平均年龄（58±10）岁。按FFR值分成FFR≤0.75组和FFR〉0.75组。采用相关分析、ROC曲线分析和Logistic回归分析判断血液学指数和FFR的关系。结果 FFR≤0.75组和FFR〉0.75组患者的白细胞计数（WBC）[（8.6±1.6）×10^9/L比（6.6±1.3）×10^9/L,P〈0.001]、中性粒细胞计数[（5.9±1.7）×10^9/L比（3.9±1.5）×10^9/L,P〈0.001]、平均血小板体积（MPV）[（10.65±1.08）f L比（9.64±1.44）f L,P〈0.001]、病变类型（P〈0.001）和Gensini评分[24.0（12.5,34.8）比12.0（8.0,20.0）,P〈0.001]比较,差异均有统计学意义,且WBC（r=-0.57,P〈0.001）、中性粒细胞计数（r=-0.56,P〈0.001）、MPV（r=-0.42,P〈0.001）和Gensini评分（r=-0.39,P〈0.001）与FFR存在不同程度的相关性。ROC曲线分析提示,WBC≥8.99×10^9/L、中性粒细胞计数≥6.19×10^9/L、MPV≥10.15 f L和Gensini评分≥19分时对FFR值≤0.75有一定的判断价值。Logistic回归分析显示,WBC（OR 1.660,95%CI 1.153-2.435,P=0.001）、MPV（OR 1.658,95%CI 1.186-2.309,P=0.003）和Gensini评分（OR 1.171,95%CI 1.020-1.223,P=0.005）为心肌血流储备功能的影响因素。结论 WBC、MPV和Gensini评分与冠心病患者心肌血流储备功能存在相关性,可为初步判断心肌血流储备功能提供依据。

Objective To investigate the association of haematological indices with fractional flow reserve（ FFR） in patients with coronary artery disease（ CAD）. Methods This study included 177 patients and 267 lesions with intermediate coronary artery stenosis. Patients were divided into two groups： FFR〉 0. 75 group and FFR≤0. 75 group. Correlation analysis was used to identify the relationship between haematological indices and FFR value. Receiver operating characteristic（ ROC） curve and Logistic regression were used to determine parameters predictive of FFR≤0. 75. Results White blood cell count（ WBC）,neutrophil count,mean platelet volume（ MPV） and Gensini score and types of CAD were different between FFR 〉0. 75 group and FFR≤0. 75 group patients. WBC count（ r =- 0. 57,P〈0. 001）,neutrophil count（ r =- 0. 56,P〈0. 001）,MPV（ r =- 0. 42,P〈0. 001） and Gensini score（ r =- 0. 39,P〈0. 001） were negatively correlated with FFR,respectively. ROC showed that WBC count,neutrophil count,MPV and Gensini score had predictive values for FFR≤0. 75. Logistic regression showed that WBC count（ OR 1. 660,95% CI 1. 153- 2. 435,P = 0. 001）,MPV（ OR 1. 658,95% CI 1. 186- 2. 309,P = 0. 003） and Gensini score（ OR1. 171,95% CI 1. 020- 1. 223,P = 0. 005） were influencing factors of FFR. Conclusions WBC count,MPV and Gensini score are associated with FFR in patients with CAD respectively,and could provide important evidence to identify FFR.