免疫炎症指数、CRP/HDL-C与老年ACS严重程度的相关性

Correlation among immune-inflammation index,CRP/HDL-C and ACS severity in aged patients

目的:研究免疫炎症指数(SII)和CRP/HDL-C比值(CHR)与老年急性冠脉综合征(ACS)严重程度的相关性。方法:我院的198例老年ACS患者被分为急性心肌梗死(AMI)组(117例)和不稳定型心绞痛(UAP)组(81例),另选择同期健康体检者80例为健康对照组。比较各组临床指标、分析SII、CHR与ACS严重程度的相关性及其预测价值。结果:与健康对照组比较,UAP组、AMI组BMI、高血压、吸烟史比例、血清TC、LDL-C、HDL-C水平、血浆CRP水平、中性粒细胞计数、淋巴细胞计数、SII、CHR及AMI组血清cTnI水平均显著升高(P<0.05或<0.01);与UAP组比较,AMI组BMI、血清TC水平均显著降低,血清cTnI、HDL-C水平、血浆CRP水平、中性粒细胞计数、淋巴细胞计数、CHR、Gensini评分均显著升高(P<0.05或<0.01)。Pearson相关性分析显示,CHR、SII与Gensini评分呈显著正相关(r=0.213、0.334,P=0.003、0.001)。ROC曲线显示,CHR预测UAP和AMI的曲线下面积(AUC)分别是0.901、0.899,最佳截断值分别为2.92、3.59;SII预测UAP和AMI的AUC分别是0.601、0.667,最佳截断值分别为659.22×10^(9)/L、563.89×10^(9)/L。多因素Logistic回归分析显示,SII、CHR是老年UAP和AMI的独立危险因素(OR=1.003~4.723,P<0.05或<0.01),HDL-C是老年UAP和AMI的独立保护因素(OR=0.043、0.356,P均=0.001)。结论:SII、CHR与老年ACS严重程度呈显著正相关,对老年UAP和AMI具有一定预测价值。

Objective:To study correlation among immune-inflammation index(SII),CRP/HDL-C ratio(CHR)and severity of acute coronary syndrome(ACS)in aged patients.Methods:The 198 aged ACS patients in our hospital were divided into acute myocardial infarction(AMI)group(n=117)and unstable angina pectoris(UAP)group(n=81).Another 80 healthy volunteers were simultaneously regarded as healthy control group.Clinical indexes were compared among three groups.Correlation among SII,CHR and severity of ACS and their predictive value were analyzed.Results:Compared with healthy control group,there were significant rise in BMI,percentages of hypertension and smoking history,serum levels of TC,LDL-C and HDL-C,plasm CRP level,neutrophil count,lymphocyte count,SII and CHR in UAP group and AMI group,and significant rise in serum cTnI level in AMI group(P<0.05 or<0.01);compared with UAP group,there were significant reductions in BMI and serum TC level in AMI group,and significant rise in serum levels of cTnI,HDL-C,plasm CRP level,neutrophil count,lymphocyte count,CHR and Gensini score in AMI group(P<0.05 or<0.01).Pearson correlation analysis indicated that CHR and SII were significant positively correlated with Gensini score(r=0.213,0.334,P=0.003,0.001).ROC curve indicated that areas under curve(AUC)of CHR for predicting UAP and AMI was 0.901 and 0.899 respectively,and optimal cutoff point was 2.92 and 3.59 respectively;AUC of SII for predicting UAP and AMI was 0.601 and 0.667 respectively,and optimal cutoff point was 659.22×10^(9)/L and 563.89×10^(9)/L respectively.Multivariate Logistic regression analysis indicated that SII and CHR were independent risk factors for UAP and AMI(OR=1.003~4.723,P<0.05 or<0.01),and HDL-C was an independent protective factor for UAP and AMI(OR=0.043,0.356,P=0.001 both)in aged patients.Conclusion:SII and CHR are significantly positively correlated with severity of ACS in aged patients,and possess certain predictive value for UAP and AMI in aged patients.