红细胞体积分布宽度、中性粒细胞淋巴细胞比值与冠状动脉病变程度及其预后的相关性研究

The Correlation between Red Cell Distribution Width,Neutrophil-to-lymphocyte Ratio and Coronary Artery Disease and its Prognosis

目的探讨红细胞体积分布宽度(RDW-CV)、中性粒细胞淋巴细胞比值(NLR)与冠状动脉病变程度及预后的相关性。方法回顾性收集2017年6月—2017年12月,在山西医科大学第二医院心内科行冠状动脉造影确诊的冠心病病人145例作为冠心病组,使用Gensini法评价其冠状动脉病变程度,并以三分位数为界,将冠心病组病人分为轻度(48例)、中度(54例)和重度(43例)3个不同病变程度的亚组,将同期冠状动脉造影未见明显异常的50例病人作为对照组。记录所有病人的基本资料、病史、各项检查化验指标、预后情况等信息,使用独立样本t检验、Pearson相关分析、单因素方差分析、多元有序Logistic回归,分析RDW-CV、NLR与冠状动脉病变程度的相关性。以RDW-CV、NLR的中位数将冠心病组分为4个组,利用Kaplan-Meier法估测并绘制生存曲线,采用Log rank检验比较两组曲线差异,研究4组病人与冠心病主要不良心血管事件(MACEs)的关系。结果冠心病组与对照组在白细胞数、中性粒细胞数、RDW-CV、NLR、同型半胱氨酸、B型利钠肽(BNP)等的差异有统计学意义(P<0.05),且RDW-CV、NLR与Gensini评分呈正相关(r=0.705,P<0.001;r=0.642,P<0.001)。空腹血糖、RDW-CV、NLR、同型半胱氨酸经多元Logistic回归检验与Gensini评分密切相关(均P<0.05)。Kaplan-Meier法和Log rank法检验结果显示,高RDW-CV、高NLR病人较低RDW-CV、低NLR病人MACEs发生率比较差异有统计学意义(P<0.001)。结论RDW-CV、NLR与冠状动脉病变程度呈正相关,RDW-CV、NLR是冠心病病人MACES发生的独立预测因子。

Objective To investigate the correlation between red cell distribution width(RDW-CV),neutrophil-to-lymphocyte ratio(NLR)and coronary artery disease and its prognosis.Methods One hundred and forty-five patients were included in the observation group.The patients in the observation group were divided into three subgroups with different degrees of coronary artery lesions,which was evaluated by Gensini method.Fifty patients without obvious abnormality in coronary angiography were included in the control group.The basic information,assay index,and prognosis information were tested in both groups.Pearson analysis,T test,univariate anova and logistic regression were used to analyze the correlation between RDW-CV,NLR,and severity of coronary artery.The patients in the observation group were divided into 4 subgroups by medians of RDW-CV and NLR,whose relationship with major adverse cardiac events(MACE)were tested by kaplan-meier and Log rank.Results The white blood cell count,neutrophil counts,RDW-CV,NLR,homocysteine,and brain natriuretic peptide in the observation group and control group showed statistically significant differences(P<0.05).The correlation between RDW-CV,NLR,and Gensini score were positive(r=0.705,P<0.001;r=0.642,P<0.001).Logistic regression analysis showed that fasting blood glucose,RDW-CV,NLR,and homocysteine were related with Gensini scores(P<0.05).The difference with high RDW-CV and high NLR and those with low RDW-CV and low NLR was statistically significant(P<0.001),which was tested by Kaplan-meier method and Log rank.Conclusion RDW-CV and NLR were positively related with the degree of coronary artery lesions,RDW-CV and NLR were independent predictors of MACE events in patients with coronary heart disease.