中性粒细胞/淋巴细胞比值与冠状动脉粥样硬化性心脏病合并抑郁的关系研究

Relationship between neutrophil/lymphocyte ratio and coronary heart disease complicated by depression

目的探讨中性粒细胞/淋巴细胞比值(NLR)与冠状动脉粥样硬化性心脏病(CHD)合并抑郁的关系及预测价值。方法回顾性分析2020年7—12月在三峡大学附属仁和医院心内科住院就诊的132例CHD患者的临床资料及相关实验室检查指标,根据出院时是否合并抑郁分为CHD抑郁组、CHD无抑郁组。比较两组患者一般资料和入院时NLR等指标之间的差异,采用二元Logistic回归分析模型评估NLR等指标与CHD患者发生抑郁的关系,绘制受试者工作特征(ROC)曲线评价其预测价值。结果两组患者年龄、性别、文化水平、户口类型、高血压史、糖尿病史、吸烟史、饮酒史、单核细胞/高密度脂蛋白胆固醇比值、血小板平均体积和红细胞分布宽度水平等临床资料比较,差异均无统计学意义(P>0.05),在婚姻状况上差异有统计学意义(P<0.05),CHD抑郁组血清NLR明显高于CHD无抑郁组(P<0.05)。二元Logistic回归分析显示,NLR(OR=2.329,95%CI:1.533~3.540,P<0.001)是影响CHD患者发生抑郁的独立危险因素。ROC曲线分析显示,NLR预测CHD患者发生抑郁的ROC曲线下面积为0.806(95%CI:0.697~0.914,P<0.001),最佳截断值为4.09,此时的灵敏度和特异度分别为65.2%和93.5%。结论血清NLR与CHD患者发生抑郁具有一定关系,临床检测血清NLR对于预测CHD患者抑郁的发生具有重要的指导意义。

Objective To explore the relationship and predictive value of neutrophil/lymphocyte ratio(NLR)and coronary heart disease(CHD)complicated by depression.Methods Clinical data and related laboratory tests of totally 132 patients with CHD who were admitted to Department of Cardiology in Renhe Hospital Affiliated to Three Gorges University from July to December 2020 were retrospectively analyzed.They were divided into CHD depression group and CHD non depression group according to whether they were complicated by depression when discharged.The differences between the general data of patients and indicators such as NLR at the time of admission between the two groups were compared.The relationship between NLR and depression in patients with CHD was assessed using binary Logistic regression model,and the receiver operating characteristic(ROC)curve was drawn to evaluate its predictive value.Results Patients in the two groups had no statistically significant difference on age,gender,educational level,type of household,hypertension,diabetes,smoking,alcohol consumption,monocyte/high density lipoprotein cholesterol ratio(MHR),mean platelet volume(MPV)and red blood cell distribution width(RDW)levels(P>0.05),while there were statistically significant differences on marital status between two groups(P<0.05).The serum NLR of the CHD depression group was significantly higher than that of the non-depression group(P<0.05).Binary Logistic regression analysis results showed that NLR(OR=2.329,95%CI:1.533-3.540,P<0.001)was an independent risk factor for the occurrence of depression in patients with CHD.ROC curve analysis showed that the area under ROC curve(AUC)of NLR in predicting the occurrence of depression in patients with CHD was 0.806(95%CI:0.697-0.914,P<0.001).The cut off value of NLR was 4.09,the sensitivity and specificity at this time were 65.2%and 93.5%respectively.Conclusion The serum NLR has a certain correlation with depression in patient with CHD,and clinical detection of serum NLR has important guiding significance for predict depression in patients with CHD.