中性粒细胞/淋巴细胞比率与原发性高血压合并冠心病的相关性研究

The correlation between the neutrophil to lymphocyte ratio and primary hypertension with coronary heart disease

目的:探讨中性粒细胞/淋巴细胞比率(NLR)与原发性高血压(EH)合并冠心病(CHD)的相关性。方法:连续入选2018年1月至6月,于承德医学院附属医院行冠脉造影(CAG)的EH患者446例,将合并CHD的患者分为观察组(349例),不合并CHD的患者分为对照组(97例),记录患者的生化检测指标、临床资料、冠状动脉影像学资料,计算Gensini评分;计数中性粒细胞(NEUT)、淋巴细胞(LYMP)数量,计算NLR。结果:观察组NLR明显高于对照组,差异有统计学意义(P<0.05);Spearman相关分析显示NLR水平与EH患者Gensini评分呈正相关(r=0.381,P<0.05);NLR诊断EH合并CHD的ROC曲线下面积为0.742,当NLR临界值取1.96时,其诊断EH合并CHD效能最高,敏感性为80.5%,特异性为51.6%;二元Logstic多因素回归分析表明年龄≥60岁、空腹血糖增高、吸烟、LDL-C增高、NLR≥1.96为EH合并CHD的影响因素;在逐步校正影响因素:年龄≥60岁、空腹血糖、吸烟、LDL-C后,NLR≥1.96仍为EH合并CHD的影响因素。结论:NLR≥1.96为EH合并CHD的影响因素,NLR水平与EH患者冠状动脉狭窄程度呈正相关,NLR对预测EH是否并发CHD具有一定的价值。

Objective:To study The correlation between the neutrophil to lymphocyte ratio(MR)and primary hypertension with coronary heart disease(CHD).Methods:A total of 446 patients diagnosed with essential hypertension(EH),349 patients with CHD were divided into study group and 97 patients without CHD were divided into control group were consecutively enrolled from June 2018 to August 2018 in the division of cardiology in our hospital.All the demographic and clinical data of the subjects were collected by the physicians and master degree candidates in the division of cardiology,and calculate the Gensini score.Count the number of neutrophils and lymphocytes,and calculate the NLR.Results:The NLR in the study group was significantly higher than that in the control group(P<0.05).Spearman correlation analysis showed a positive correlation between NLR level and Gensini score in EH patients(r=0.381,P<0.05).ROC curve analysis showed that the area under the curve of NLR was 0.742,and when the threshold value of NLR was 1.96,the diagnostic efficiency of EH with CHD was the highest,with a sensitivity of 80.5%and a specificity of 51.6%.Binary Logstic multiple factors regression analysis showed that age≥60 years,increased fasting glucose,smoking,increased LDL-C,NLR≥1.96 is independent risk factor for EH merging CHD.After gradually adjusting for risk factors:age≥60 years,increased fasting glucose,smoking,increased LDL-C,NLR≥1.96 remains an independent risk factor for EH merging CHD.Conclusions:NLR≥1.96 is an independent risk factor for EH with CHD,and The level of NLR is positively correlated with the degree of coronary stenosis in EH patients,which has certain value in predicting the occurrence risk of EH with CHD.