单核细胞/高密度脂蛋白胆固醇比值对下肢动脉狭窄的诊断价值

Diagnostic value of monocyte to high density lipoprotein cholesterol ratio in lower extremity arterial stenosis

目的探讨外周血单核细胞/高密度脂蛋白胆固醇比值(MHR)对下肢动脉狭窄的诊断价值。方法选取2018年8月—2020年8月在中山大学附属第八医院就诊的连续性病例311例,根据下肢动脉狭窄程度不同将患者分为4组:(1)对照组(n=65):下肢动脉正常;(2)轻度病变组(n=77):30%≤下肢动脉狭窄<50%;(3)中度病变组(n=60):50%≤下肢动脉狭窄≤75%;(4)重度病变组(n=109):下肢动脉狭窄>75%或闭塞。计算MHR。收集并比较4组患者临床资料、实验室检查结果。分析患者发生下肢动脉狭窄的影响因素及MHR对下肢动脉狭窄的诊断价值。结果4组之间年龄、MHR、高敏C反应蛋白、血红蛋白、高密度脂蛋白胆固醇、血清肌酐(SCr)、血尿酸、血同型半胱氨酸、高血压病史及糖尿病病史比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,高龄、高MHR、高SCr和糖尿病病史是患者发生下肢动脉狭窄的危险因素(P<0.05)。根据多因素Logistic回归模型所得预测概率作ROC曲线,曲线下面积为0.953;当预测概率取0.86时,诊断下肢动脉狭窄的灵敏度为85.8%,特异度为92.3%。结论高MHR是下肢动脉狭窄发生的危险因素。本文所建立的多因素Logistic回归模型对下肢动脉狭窄有较高的诊断价值。

Aim To explore the diagnostic value of peripheral blood monocyte to high density lipoprotein cholesterol ratio(MHR)in lower extremity arterial stenosis.Methods 311 consecutive cases treated in the Eighth Affiliated Hospital of Sun Yat-sen University from August 2018 to August 2020 were selected.According to the degree of lower extremity arterial stenosis,the patients were divided into four groups:(1)control group(n=65):lower extremity artery was normal;(2)mild lesion group(n=77):30%≤lower extremity arterial stenosis<50%;(3)moderate lesion group(n=60):50%≤lower extremity arterial stenosis≤75%;(4)severe lesion group(n=109):lower extremity arterial stenosis>75%or occlusion.MHR was calculated.The clinical data and laboratory results of the four groups were collected and compared.The influencing factors of lower extremity arterial stenosis and the diagnostic value of MHR in lower extremity arterial stenosis were analyzed.Results The differences in age,MHR,high-sensitivity C-reactive protein,hemoglobin,high-density lipoprotein cholesterol,serum creatinine(SCr),blood uric acid,blood homocysteine,history of hypertension,and history of diabetes were statistically significant among the four groups(P<0.05).Multivariate Logistic regression analysis showed that advanced age,high MHR,high SCr and history of diabetes were risk factors for patients with lower extremity arterial stenosis(P<0.05).Based on the predicted probability obtained from the multivariate Logistic regression model,the ROC curve was drawn,and the area under the curve was 0.953;When the predicted probability is 0.86,the sensitivity and specificity for the diagnosis of lower extremity arterial stenosis were 85.8%and 92.3%.Conclusions High MHR is a risk factor for lower extremity arterial stenosis.The multivariate Logistic regression model established in this article has a high diagnostic value for lower extremity arterial stenosis.