冠心病患者MHR与冠脉狭窄程度的相关性及其临床意义

Correlation between monocyte to high density lipoprotein cholesterol ratio and the severity of coronary artery stenosis in patients with coronary heart disease and clinical significance

目的 探讨冠心病患者单核细胞数与高密度脂蛋白胆固醇比值(MHR)与冠状动脉狭窄程度的相关性及其临床意义。方法 冠脉造影患者407例,根据造影结果分冠心病组(冠脉狭窄程度≥50%)306例和对照组(冠脉狭窄程度<50%)101例,冠脉狭窄程度用Gensini积分表示,收集并比较两组临床资料差异,采用多因素Logisitic回归分析影响冠脉狭窄程度的因素,采用Pearson相关分析MHR与Gensini积分相关性,采用ROC曲线分析MHR诊断冠心病的价值。结果 冠心病组Gensini积分、MHR、单核细胞计数、总胆固醇、甘油三酯、低密度脂蛋白胆固醇高于对照组(均P<0.01),高密度脂蛋白胆固醇低于对照组(P<0.01);多因素Logisitic回归分析显示MHR是影响冠脉狭窄程度的独立因素(Wald χ^2=10.397,P<0.01);Pearson相关分析示冠心病患者MHR与冠脉Gensini积分呈正相关(r=0.672,P<0.05);ROC曲线显示MHR曲线下面积为0.742(95%CI:0.693-0.792),当MHR截断点为0.35时,其诊断效率最高,灵敏度为62.7%,特异度为77.2%,准确度为73.5%。结论 冠心病患者MHR是冠脉狭窄程度的独立相关因素,可作为临床诊断冠心病的重要参考指标。

AIM To investigate the relationship between monocyte to high density lipoprotein cholesterol ratio(MHR)and severity of coronary artery stenosis in patients with coronary heart disease and its clinical significance.METHODS 407 patients who underwent coronary angiography from July 2017 to April 2018 in the second Hospital of Shanxi Medical University were divided into a coronary artery disease group(coronary artery stenosisd≥50%,n=306)and a control group(coronary artery stenosis<50%,n=101).The degree of coronary stenosis was expressed by Gensini score.The clinical data of the two groups were collected and compared.Multivariate Logisitic regression analysis was used to analyze factors affecting degree of coronary artery stenosis.Pearson correlation analysis was used to analyze the correlation between MHR and coronary Gensini score in patients with coronary heart disease and a ROC curve was used to analyze the value of MHR in the diagnosis of coronary heart disease.RESULTS The Gensini score,monocyte count,low density lipoprotein cholesterol,total cholesterol and triglyceride levels in the coronary heart disease group were higher than those in the control group(all P<0.01)and the level of high density lipoprotein cholesterol was lower than that in the control group(P<0.01).Multivariate Logisitic regression analysis showed that MHR was an independent factor affecting the degree of coronary artery stenosis(Waldχ^2=10.397,P<0.01).Pearson correlation analysis showed that there was a significant positive correlation between MHR and coronary Gensini score in patients with coronary heart disease(r=0.672,P<0.05).The area under MHR of ROC curve was 0.742(95%CI:0.693-0.792).When the MHR cut-off point was 0.35,the diagnostic efficiency reached highest,the sensitivity was 62.7%,the specificity was 77.2%and the accuracy was 73.5%.CONCLUSION MHR is an independent correlation factor of coronary stenosis and can be used as an important reference index for clinical diagnosis of coronary artery disease.