中性粒细胞/淋巴细胞比值对胸痛患者冠状动脉重度狭窄的早期识别价值

Early identification of neutrophil-to-lymphocyte ratio for severe coronary artery stenosis in patients with chest pain

目的:探索中性粒细胞/淋巴细胞比值(NLR)与冠状动脉狭窄的相关性及其对冠状动脉重度狭窄的早期识别价值。方法:连续收集2010年10月至2011年3月在西安交通大学第一附属医院行冠状动脉造影的484例胸痛患者,根据美国心脏协会(AHA)冠状动脉分段评价标准和Gensini积分系统对每支血管进行定量评分并计算总积分,根据Gensini积分结果分为轻度狭窄组(>30分)与重度狭窄组(≤30分),并根据血常规结果计算NLR,分析NLR与冠状动脉狭窄之间的相关性及其对冠状动脉重度狭窄的早期识别价值。结果:多因素logistic回归分析显示,高龄(OR=1.033,95%CI:1.013~1.054,P=0.001)、男性(OR=1.750,95%CI:1.062~2.883,P=0.028)、低密度脂蛋白(OR=1.723,95%CI:1.232~2.411,P=0.001)、NLR(OR=1.345,95%CI:1.205~1.500,P<0.001)为冠状动脉狭窄的独立危险因素;NLR受试者工作特征(ROC)曲线下面积为0.643(95%CI:0.594~0.693,P<0.01),当NLR取值为2.32时,其诊断效率最高,敏感度为78.5%,特异度为62.6%。结论:NLR是冠状动脉重度脉狭窄的独立危险因素,对冠状动脉狭窄程度的评估具有一定价值。

Objective:To investigate the early identification of NLR for severe coronary artery stenosis in patients with chest pain.Methods:Clinical data of484patients who had undergone coronary angiography owing to pectoris symptom were retrospectively analyzed.Patients were divided into severe stenosis group and mild stenosis group based on Gensini scores.Logistic regression and receiver operator characteristic curve were used to analyze early identification of NLR for coronary artery stenosis.Results:Using multiple logistic regression analysis,advanced ages(OR=1.033,95%CI:1.013-1.054,P=0.001),male(OR=1.750,95%CI:1.062-2.883,P=0.028),LDL-C(OR=1.723,95%CI:1.232-2.411,P=0.001),and NLR(OR=1.345,95%CI:1.205-1.500,P<0.001)emerged as independent identification for the severe coronary artery stenosis.In receiver operating characteristics curve analysis,NLR>2.32had78.5%sensitivity and62.6%specificity in identify the severity of coronary artery stenosis.Conclusion:High NLR is a powerful identification for the sverity of coronary artery stenosis in patients with chest pain.