单核细胞/高密度脂蛋白比值与冠心病患者冠状动脉狭窄的关系

Relationship between monocyte/high-density lipoprotein ratio and coronary artery stenosis in patients with coronary heart disease

目的分析单核细胞/高密度脂蛋白胆固醇比值(MHR)水平与冠心病(CHD)患者冠状动脉狭窄程度的关系。方法本研究纳入2019年2月至2021年12月长沙市第三医院住院的CHD患者127例,根据冠状动脉造影结果将其分为CHD组(97例)和非CHD组(30例),比较两组临床资料、实验室生化指标及MHR水平的差异,并分析CHD组MHR水平与其他指标的相关性。另根据CHD组的Gensini评分结果将其分为轻度组31例(<20分),中度组35例(20~43分),重度组31例(>43分),比较三组MHR的差异,并分析CHD组MHR水平与Gensini评分的相关性,采用受试者操作特征曲线评价MHR预测CHD患者冠状动脉狭窄的诊断效能。结果CHD组男性占比、吸烟史占比、2型糖尿病占比、高血压史占比、空腹血糖、低密度脂蛋白胆固醇、尿酸、超敏C反应蛋白、白细胞、髓过氧化物酶、MHR均高于非CHD组,差异有统计学意义(P<0.05)。相关性分析结果显示,CHD组MHR与低密度脂蛋白胆固醇、尿酸、超敏C反应蛋白、髓过氧化物酶、白细胞均呈正相关(r>0,P<0.05)。高度组MHR高于中度组、轻度组,中度组MHR高于低度组,差异有统计学意义(P<0.05)。相关性分析结果显示,CHD组MHR与Gensini评分呈正相关(r>0,P<0.05)。MHR预测CHD患者冠状动脉狭窄的受试者操作特征曲线下面积为0.929(95%CI:0.885~0.974,P<0.05),截断值为0.42,灵敏度为78.0%,特异度为90.0%。结论MHR可作为CHD早期诊断、评估冠状动脉病变的炎症标志物。

Objective To analyze the relationship between monocyte/high-density lipoprotein cholesterol ratio(MHR)and coronary artery stenosis in patients with coronary artery heart disease(CHD).Methods In this study,127 CHD patients admitted to the Third Hospital of Changsha from February 2019 to December 2021 were divided into CHD group(97 cases)and non-CHD group(30 cases)according to the results of coronary angiography.The differences of clinical data,laboratory biochemical indexes,and MHR levels between the two groups were compared,and the correlation between serum MHR level and other indexes in CHD group was analyzed.According to the Gensini score of CHD group,the patients were divided into mild group(31 cases)(<20 points),moderate group(35 cases)(20-43 points),and severe group(31 cases)(>43 points).The difference of MHR among the three groups was compared,the correlation between the MHR level and Gensini score in the CHD group was analyzed,and the diagnostic efficacy of MHR in predicting coronary artery stenosis in CHD patients was evaluated by receiver operator characteristic curve.Results The male proportion,smoking history proportion,type 2 diabetes mellitus proportion,hypertension history proportion,fasting blood glucose,low-density lipoprotein cholesterol,uric acid,hypersensitive C-reactive protein,white blood cell,myeloperoxidase,and MHR in CHD group were all higher than those in non-CHD group,and the differences were statistically significant(P<0.05).Correlation analysis showed that MHR in CHD group was positively correlated with low-density lipoprotein cholesterol,uric acid,hypersensitive C-reactive protein,myeloperoxidase,and leukocyte(r>0,P<0.05).The MHR of the severe group was higher than that of the mild and moderate groups,and the MHR of the moderate group was higher than that of the mild group,the differences were statistically significant(P<0.05).Correlation analysis showed that MHR in CHD group was positively correlated with Gensini score(r>0,P<0.05).MHR predicted coronary artery stenosis in CHD patients with the area under the receiver operator characteristic curve of 0.929(95%CI:0.885-0.974,P<0.05),truncation value of 0.42,sensitivity of 78.0%,specificity of 90.0%.Conclusion MHR can be used as an inflammatory marker for early diagnosis and evaluation the severity of coronary artery disease.