老年高血压患者血小板与淋巴细胞比值对代谢综合征的预测价值

Value of platelet to lymphocyte ratio for predicting metabolic syndrome in elderly hypertensive patients

目的探讨老年高血压患者血小板/淋巴细胞比值(PLR)对代谢综合征(MS)的预测价值。方法选择老年原发性高血压患者431例,根据诊断分为MS组204例和非MS组227例。又根据MS组分数目分为1分组102例、2分组125例、3分组145例、4和5分组59例。收集患者的临床基线资料,分析PLR与MS及其各组分的关系。结果与非MS组比较,MS组收缩压、体质量指数、腰围、血小板计数、PLR、空腹血糖及TG水平明显升高,淋巴细胞和HDL-C水平明显降低(P<0.05,P<0.01)。不同MS亚组PLR、空腹血糖、TG、HDL-C水平比较,差异有统计学意义(P<0.01)。logistic回归分析显示,PLR为老年高血压合并MS患者的危险因素(OR=2.942,95%CI:1.845~5.905,P<0.01)。ROC曲线分析显示,PLR预测老年高血压合并MS患者的ROC曲线下面积为0.724(95%CI:0.674~0.774,P<0.01),PLR截断值为127.3,敏感性为76.9%,特异性为57.2%。结论 PLR是老年高血压合并MS患者的独立危险因素,有助于为MS的防治提供临床依据。

Objective To study the value of platelet to lymphocyte ratio(PLR) for predicting metabolic syndrome(MS) in elderly hypertensive patients.Methods Four hundred and thirty-one elderly primary hypertension patients were divided into MS group(n=204) and MS-free group(n=227) according to the diagnostic criteria of MS and into group 1(n=102),group 2(n=125),group 3(n=145),group 4+5(n=59) according to the MS components.Their general clinical data were recorded.The relationship of PLR with MS and its components in elderly hypertensive patients was analyzed.Results The SBP,BMI,PLR,serum FBG and TG levels were significantly higher, the waist circumference was significantly longer, the number of platelets was significantly greater while the number of lymphocytes was significantly smaller and the serum HDL-C level was significantly lower in MS group than in MS-free group(P<0.05,P<0.01).Significant difference was detected in PLR,serum FBG,TG and HDL-C levels in different MS subgroups(P<0.01).Logistic regression analysis showed that PLR was an independent risk factor for MS in elderly hypertensive patients(OR=2.942,95%CI:1.845-5.905,P<0.01).ROC curve analysis displayed that the AUC of PLR for predicting MS in elderly hypertensive patients was 0.724(95%CI:0.674-0.774,P<0.01) with an optimal cut-off value of 127.3,a sensitivity of 76.9% and a specificity of 57.2%.Conclusion PLR is an independent risk factor for MS in elderly hypertensive patients and can thus provide the clinical evidence for its prevention and treatment.