单核细胞/高密度脂蛋白胆固醇比值与急性ST段抬高型心肌梗死患者血栓负荷的关系

Relationship Between Monocyte to HDL-Cholesterol Ratio and Thrombus Burden in Patients With ST-segment Elevation Myocardial Infarction

目的:通过分析急性ST段抬高型心肌梗死(STEMI)患者单核细胞计数及单核细胞/高密度脂蛋白胆固醇比值(MHR)与冠状动脉内血栓负荷程度的关系,探讨MHR预测STEMI患者血栓负荷程度的能力。方法:选取2015-01至2016-12我院就诊的STEMI患者357例,根据造影确定血栓负荷程度分为低血栓负荷组156例,高血栓负荷组201例,比较两组MHR。同时通过Logistic回归分析及绘制受试者工作特征(ROC)曲线,评估STEMI患者中MHR预测血栓负荷程度的能力。结果:高血栓负荷组患者MHR高于低血栓负荷组[M(Q1,Q3)25.4(13.5,44.6)vs 16.0(9.2,22.1),P<0.001]。多因素Logistic回归分析显示,MHR是高血栓负荷发生的独立危险因素(比值比=1.067,95%可信区间:1.031~1.105,P<0.001)。STEMI患者MHR的ROC曲线下面积为0.688。结论:MHR是STEMI患者高血栓负荷的独立预测因子。

Objective： To analyze the relationship between monocyte to high-density lipoprotein cholesterol（HDL-C） ratio（MHR） in patients with ST-segment elevation myocardial infarction（STEMI） in order to explore the predictive value of MHR in thrombus burden level in STEMI patients.Methods： A total of 357 STEMI patients treated in our hospital from 2015-01 to 2016-12 were enrolled. Thrombus burden was confirmed by angiography and the patients were divided into 2 groups： Low thrombus burden group, n =156 and High thrombus burden group, n=201. MHR was compared between 2 groups; the predictive value of MHR in thrombus burden level was studied by multivariate Logistic regression analysis and ROC curve assessment.Results： MHR was higher in High thrombus burden group than that in Low thrombus burden group [M（Q1, Q3） 25.4（13.5, 44.6） vs 16.0（9.2, 22.1）], P0.001; multivariate Logistic regression analysis indicated that MHR was the independent predictor for high thrombus burden occurrence（OR=1.067, 95% CI 1.031-1.105）, P0.001; the area under ROC curve for MHR was 0.688 in STEMI patients.Conclusion： MHR was the independent predictor for high thrombus burden occurrence in STEMI patients.