不稳定型心绞痛患者MHR、MLR和NLR与冠状动脉病变程度的关系

Relationship Between MHR,MLR,NLR and Severity of Coronary Artery Disease in Patients with Unstable Angina

目的探讨不稳定型心绞痛(UA)患者单核细胞/高密度脂蛋白胆固醇比值(MHR)、单核细胞/淋巴细胞比值(MLR)和中性粒细胞/淋巴细胞比值(NLR)与冠状动脉病变程度的关系。方法回顾性分析确诊为UA并行冠脉造影患者285人,根据冠状动脉造影结果,分为对照组(冠脉造影结果完全正常或冠状动脉狭窄<50%的患者)和冠脉病变组(单支及以上冠状动脉狭窄≥50%的患者,根据Gensini评分三分位数分为轻度亚组Gensini评分<27分、中度亚组Gensini评分为27~52分、以及重度亚组Gensini评分>52分),分析MHR、MLR和NLR与Gensini评分之间的关系。结果冠脉病变组的MHR、MLR及NLR明显高于对照组(U值分别为8970.5、10153、9155.5,P<0.01),UA患者中MHR、MLR、NLR均与Gensini评分呈正相关(r=0.319,P<0.01;r=0.411,P<0.01;r=0.228,P<0.01),受试者工作特征(ROC)曲线分析:MHR的曲线下面积(AUC)为0.709(95%CI:0.624~0.794,P<0.01);MLR的AUC为0.803(95%CI:0.745~0.861,P<0.01);NLR的AUC为0.724(95%CI:0.645~0.803,P<0.01);三者联合检测的AUC为0.809(95%CI:0.751~0.867,P<0.01)。结论MHR、MLR及NLR与UA严重程度Gensini评分呈正相关,且MHR、MLR及NLR值越高,UA冠脉病变越严重。三者联合检测对不稳定型心绞痛的冠状动脉病变程度具有一定的预测价值。

Objective To investigate the relationship between the ratios of monocyte/high density lipoprotein cholesterol(MHR),monocyte/lymphocyte(MLR),and neutrophil/lymphocyte(NLR)and severity of coronary artery disease in the patients with unstable angina(UA).Methods A total of 285 patients with UA and coronary angiography were retrospectively analyzed.According to the results of coronary angiography,they were divided into control group(patients with complete normal results of coronary angiography or coronary artery stenosis<50%)and coronary lesion group(patients with single or more coronary artery stenosis≥50%).According to Gensini score,the patients were divided into mild subgroup with Gensini score<27,moderate subgroup with Gensini score of 27-52,and severe subgroup with Gensini score>52.The relationship between MHR,MLR,NLR and Gensini score was analyzed.Results MHR,MLR and NLR in the coronary lesion group were significantly higher than those in the control group(U=8970.5,10153,9155.5,respectiuely P<0.01).MHR,MLR and NLR in UA patients were positively correlated with Gensini score(r=0.319,P<0.01;r=0.411,P<0.01;r=0.228,P<0.01).The receiver operating characteristic(ROC)curve analysis of subjects was as follows:the area under the curve(AUC)of MHR was 0.709(95%CI:0.624~0.794,P<0.01);AUC of MLR was 0.803(95%CI:0.745~0.861,P<0.01);AUC of NLR was 0.724(95%CI:0.645~0.803,P<0.01);AUC of the three combined testing was 0.809(95%CI:0.751~0.867,P<0.01).Conclusion MHR,MLR and NLR are positively correlated with Gensini score of UA severity.The higher the values of MHR,MLR and NLR were,the more serious the coronary lesions of UA were.The combined detection of the three has a certain predictive value for the severity of coronary artery lesions in unstable angina.