单核细胞/高密度脂蛋白胆固醇比值对高血压患者冠状动脉钙化的预测价值

Predictive value of monocyte to high density lipoprotein cholesterol ratio for coronary artery calcification in patients with hypertension

目的探讨单核细胞/高密度脂蛋白胆固醇比值(MHR)对高血压患者冠状动脉钙化的预测价值。方法收集2018年7月至2020年12月于徐州医科大学附属医院心内科就诊的高血压患者153例,根据冠状动脉CT血管造影(CTA)结果,分为冠状动脉非钙化组和冠状动脉钙化组,收集患者一般资料及实验室检测结果,并计算出MHR。采用Pearson法分析MHR与冠状动脉钙化评分(CACS)分值的相关性。采用ROC曲线分析MHR对高血压患者冠状动脉钙化是否存在预测价值。结果高血压患者冠状动脉非钙化组与冠状动脉钙化组在年龄、吸烟、糖尿病、白细胞数、单核细胞数、高密度脂蛋白胆固醇及MHR水平方面比较差异具有统计学意义(P<0.05)。不同钙化程度的高血压患者之间MHR与CACS分值比较差异具有统计学意义(P<0.05);随着钙化程度的加剧,MHR水平也随之增加(P<0.05)。高血压患者MHR与CACS分值呈正相关(r=0.475,P<0.01)。ROC曲线分析显示,MHR预测冠状动脉钙化的曲线下面积(AUC)为0.684(95%CI:0.600~0.767,P<0.01),最佳临界值为0.310时,其敏感度和特异度分别为0.671和0.592。MHR预测冠状动脉重度钙化的AUC为0.828(95%CI:0.741~0.915,P<0.01),最佳临界值为0.361时,其敏感度和特异度分别为0.852和0.673。结论高血压患者MHR随着冠状动脉钙化程度的加重而升高,MHR对高血压患者冠状动脉钙化具有一定的预测价值。

Objective To explore the predictive value ofmonocytetohigh density lipoproteincholesterol ratio(MHR)forcoronary artery calcification in patients with hypertension.Methods A total of 153 hypertension patientswho were admitted to Department of Cardiology,the Affiliated Hospital of Xuzhou Medical University from July 2018 to December 2020,were enrolled.According to coronary CT angiography(CTA)results,they were divided into two groups:a coronary artery non-calcification group and a coronary artery calcification group.Their general informationand laboratory test results were collected to calculate MHR.The correlation between MHR and coronary artery calcification scores(CACS)was analyzed by Pearson method.A receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of MHR for coronary artery calcification in patients with hypertension.Results There were significant differences in age,smoking,diabetes,white blood cell count,monocyte count,high density lipoprotein cholesterol and MHR between non-calcified coronary artery group and calcified coronary artery group(P<0.05).There were statistical differences in MHR and CACS among patients with different degrees of calcification(P<0.05).MHR increased as calcification aggravated(P<0.05).MHR was positively related to CACS in hypertensive patients(r=0.475,P<0.01).According to ROC curve analysis,the area under curve(AUC)of MHR for predicting coronary artery calcification was 0.684(95%CI:0.600-0.767,P<0.01).The sensitivity and specificity of MHR were 0.671 and 0.592,respectively,when the optimal cutoff value was 0.310.The AUC of MHR for predicting severe calcification of the coronary artery was 0.828(95%CI:0.741-0.915,P<0.01),and the sensitivity and specificity were 0.852 and 0.673,respectively,when the optimal cutoff value was 0.361.Conclusions MHR increases with the aggravation of coronary artery calcification in patients with hypertension,which has certain predictive value for coronary artery calcification in patients with hypertension.