慢性阻塞性肺疾病患者血小板和淋巴细胞比值水平与其发生冠心病的关系研究

The relationship between platelet lymphocyte rate level and coronary artery disease in COPD patients

目的探讨血小板和淋巴细胞比值与慢性阻塞性肺疾病(COPD)患者发生冠心病的关系。方法收集2013年3月至2014年8月入院COPD患者415例,记录所有患者的一般临床资料及实验室指标,根据患者是否合并冠心病分为合并冠心病组177例和不合并冠心病组238例,比较2组患者的一般临床资料及实验室指标;采用多因素回归分析找出冠心病发生的独立危险因素;并以血小板和淋巴细胞的比值预判COPD患者冠心病的发生,绘制受试者工作特征(ROC)曲线。结果在COPD患者中,冠心病的发生率为42.7%,相对于不合并冠心病组,合并冠心病组的吸烟率、合并高血压率及糖尿病率、血小板和淋巴细胞的比值、尿酸水平显著增高,而血红蛋白、淋巴细胞、高密度脂蛋白水平显著降低(P<0.05);在校正相关因素后,血小板和淋巴细胞的比值仍是冠心病发生的独立危险因素[OR(95%CI)=1.003(1.001,1.005),(P<0.01)];以血小板和淋巴细胞的比值预判冠心病发生绘制ROC曲线,其曲线下面积为0.557(P=0.048)。结论在除外常规危险因素,年龄、吸烟史、合并高血压病史及高尿酸血症以外,血小板和淋巴细胞的比值与COPD患者发生冠心病的关系密切,可能有潜在的预测价值。

Objective To investigate the relationship between the ratio of platelet to lymphocyte and coronary heart disease in patients with chronic obstructive pulmonary disease(COPD).Method Four hundred and fifteen patients with hospitalized COPD from March 2013 to August 2014 were collected,and the general clinical data and laboratory indicators of all patients were recorded.According to whether the patients had combined coronary heart disease,they were divided into the combined coronary heart disease group(n=177)and the non-combined coronary heart disease group(n=238),and the general clinical data and laboratory indicators of the two groups were compared.Multivariate regression analysis was used to identify the independent risk factors for coronary heart disease.The ratio of platelets to lymphocytes was used to predict the incidence of coronary heart disease in COPD patients,and the ROC curve was drawn.Results In patients with COPD,the incidence of coronary heart disease was 42.7%,relative to the merger of coronary heart disease group,merger smoking rates of coronary heart disease group,the rate of hypertension and diabetes rates,platelets,and the ratio of lymphocytes,uric acid level increased significantly,and hemoglobin,lymphocyte,high-density lipoprotein cholesterol were significantly reduced(P<0.05);After adjusting for correlation factors,the ratio of platelets to lymphocytes was still an independent risk factor for coronary heart disease[OR(95%CI)=1.003(1.001,1.005),P<0.01].The ratio of platelets to lymphocytes was used to predict the incidence of coronary heart disease.The area under the ROC curve was 0.557(P=0.048).Conclusion In addition to conventional risk factors,age,smoking history,combined history of hypertension and hyperuricemia,the ratio of platelets to lymphocytes is closely related to coronary heart disease in COPD patients,which may have potential predictive value.