单核细胞/淋巴细胞比率与冠心病病变严重程度的相关性研究

Study on the Correlation between the Ratio of Monocytes/lymphocytes and the Severity of Coronary Heart Disease

目的探讨单核细胞/淋巴细胞比率(MLR)与冠心病病变严重程度的相关性。方法方便选择2018年1月—2020年6月无锡市惠山区人民医院收治的160例冠心病患者为研究组(病变严重程度:轻度55例,中度45例,重度60例;病变支数:单支病变72例,双支病变31例,三支病变57例),50例冠状动脉造影示冠脉狭窄≤50%的患者作为对照组。采集两组受检者5 mL空腹肘静脉血,离心取上清液,测定淋巴细胞、单核细胞,计算MLR。比较不同组别受检者、不同病变严重程度、病变支数冠心病患者MLR水平差异,分析MLR与冠心病病变严重程度相关性以及MLR预测冠心病价值。结果研究组MLR(0.29±0.09),高于对照组的(0.19±0.05),差异有统计学意义(t=7.495,P<0.001);轻度、中度、重度病变冠心病患者MLR水平分别为(0.24±0.06)、(0.28±0.09)、(0.34±0.10),差异有统计学意义(F=20.076,P<0.001);单支、双支、三支病变冠心病患者MLR水平分别为(0.23±0.05)、(0.29±0.07)、(0.36±0.11),差异有统计学意义(F=42.130,P<0.001);MLR与冠心病病变严重程度呈正相关(r=0.322,P<0.001);MLR预测冠心病ROC曲线下面积为0.710(95%CI:0.619~0.798),MLR临界值取0.187时预测冠心病价值最高,特异度和敏感度分别为50.21%、82.61%。结论MLR参与冠心病发生、进展,其水平高低与冠心病病变严重程度呈正相关,可将其作为冠心病诊断、病情评估和预后预测的常用指标。

Objective To investigate the correlation between the monocyte/lymphocyte ratio(MLR)and the severity of coronary heart disease.Methods 160 patients with coronary heart disease admitted to the People's Hospital of Huishan District,Wuxi City from January 2018 to June 2020 were conveniently selected as the study group(lesion severity:55 cases of mild,45 cases of moderate,and 60 cases of severe;number of lesions:72 cases of single-vessel disease,31 cases of double-vessel disease,57 cases of three-vessel disease),50 patients with coronary artery stenosis≤50%as the control group.Collected 5 mL fasting cubital venous blood from the two groups of subjects,centrifuge to take the supernatant,determine lymphocytes and monocytes,and calculate MLR.The differences in MLR levels of patients with coronary heart disease in different groups,different severity of lesions,and number of lesions were compared,and the correlation between MLR and coronary heart disease severity and the value of MLR in predicting coronary heart disease were analyzed.Results The MLR of the study group(0.29±0.09)was higher than that of the control group(0.19±0.05),the difference was statistically significant(t=7.495,P<0.001);the MLR levels of patients with mild,moderate,and severe coronary heart disease were respectively(0.24±0.06),(0.28±0.09),(0.34±0.10),the difference was statistically significant(F=20.076,P<0.001);MLR levels in patients with single-vessel,double-vessel,and three-vessel coronary heart disease were(0.23±0.05),(0.29±0.07),(0.36±0.11),the difference was statistically significant(F=42.130,P<0.001);MLR was positively correlated with the severity of coronary heart disease lesions(r=0.322,P<0.001);the area under the ROC curve for MLR predicting coronary heart disease was 0.710(95%CI:0.619-0.798).When the MLR cut-off value is 0.187,the value of predicting coronary heart disease is the highest,with specificity and sensitivity of 50.21%and 82.61%,respectively.Conclusion MLR is involved in the occurrence and progression of coronary heart disease,and its level is positively correlated with the severity of coronary heart disease.It can be used as a common indicator for coronary heart disease diagnosis,disease evaluation and prognosis prediction.