单核细胞计数与高密度脂蛋白比值预测冠脉病变的研究

Research on the ratio of monocyte to HDL in the prognosis of coronary artery lesion

目的研究单核细胞计数与高密度脂蛋白比值(MHR)与冠脉病变范围和Gensini评分的关系,并探讨MHR预测冠脉病变的价值。方法选择蚌埠市第一人民医院经冠脉造影确诊为冠脉病变(冠脉病变50%及以上)的患者165例,根据冠脉造影结果分为A组(56例,单支病变者)、B组(54例,2支病变者)、C组(55例,左主干病变或3支及3支以上病变者)3组;根据Gensini积分分为Ⅰ组(59例,Gensini积分≤20分)、Ⅱ组(51例,Gensini积分21~40分)、Ⅲ组(55例,Gensini积分>40分)。探讨MHR与冠脉病变范围的关系及其与Gensini评分的相关性。结果C组MHR显著高于A、B两组(P<0.01),B组MHR显著高于A组(P<0.01)。相关性分析显示MHR与Gensini积分呈正相关,Ⅰ组r=0.97,P<0.01;Ⅱ组r=0.979,P<0.01;Ⅲ组r=0.957,P<0.01。ROC曲线显示MHR下面积为0.657(95%CI:0.572~0.741),当MHR诊断临界值取0.42时,其诊断效率最高,敏感性为50.9%,特异性为68.2%。结论患者冠脉病变范围越大,其MHR水平越高,MHR可作为预测冠脉病变程度的重要临床参考值。

Objective TO study the correlation between monocyte/high density lipoprotein ratio(MHR)and the scope of coronary artery lesion and the Gensini score,and to investigate the value of MHR in predicting the coronary artery lesion.Methods A total of 165 patients who were examined by the coronary angiography(CAG)in the Bengbu First People's Hospital were enrolled.(the obstructive lesions≥50%).According to the result of CAG,patients were divided into three groups,the A group(n=56,plaque with single coronary artery group),the B group(n=54,plaque with double coronary artery group),the C group(n=55,mainstem stenosis or plaque with triple coronary artery group).According to the Gensini score,patients were divided into three groups,theⅠgroup(n=59,Gensini≤20),theⅡgroup(n=51,21≤Gensini≤40),theⅢgroup(n=55,Gensini>40).The correlation of MHR with coronary lesions and the Gensini score were analyzed.Results The MHR in the C group was the highest among the three groups,and the MHR in the B group was higher than that in the A group,both with significant differences(P<0.01).Correlation analysis showed that MHR was positively correlated with the Gensini score.TheⅠgroup r=0.97,P<0.01;TheⅡgroup r=0.979,P<0.01;TheⅢgroup r=0.957,P<0.01.The area under MHR of ROC curve was 0.657(95%CI:0.572 to 0.741).And when the critical value of MHR was 0.42,the diagnostic efficiency reached the highest,with the sensitivity of 50.9%,and the specificity of 68.2%.Conclusion The larger of coronary artery lesion is,the higher level of MHR will be.So it can be valuable for predicting the severity of coronary artery lesion.