红细胞分布宽度和半乳糖凝集素3及中性粒细胞淋巴细胞比值与冠心病并发心房颤动关系及意义

Association of RDW,Gal-3,and NLR with coronary artery disease complicated by atrial fibrillation and their predictive value

目的探讨红细胞分布宽度(RDW)、半乳糖凝集素3(Gal-3)、中性粒细胞淋巴细胞比值(NLR)与冠心病并发心房颤动(房颤)的关系及对其的预测价值。方法选取2020年2月~2022年3月承德市中心医院134例冠心病无房颤(冠心病组)与134例冠心病并发房颤患者(房颤组)进行双中心前瞻性研究,比较两组RDW、Gal-3、NLR水平,采用logistic回归分析冠心病并发房颤的相关影响因素,采用受试者工作特征曲线(ROC)分析RDW、Gal-3、NLR及三者联合评估房颤价值,应用Spearman分析RDW、Gal-3、NLR与房颤症状严重程度关系。结果房颤组RDW为(13.59±0.76)%,Gal-3为(57.23±15.08)pg/ml,NLR为(2.87±0.51),高于冠心病组的(12.46±0.88)%、(49.66±11.95)pg/ml、(2.19±0.67)(P<0.05);校正了冠心病病程、CCS心绞痛分级后,RDW、Gal-3、NLR仍与冠心病并发房颤显著相关(P<0.05);RDW、Gal-3、NLR以及三者联合评估冠心病并发房颤的AUC分别为0.746、0.750、0.729、0.912;RDW(r=0.750)、Gal-3(r=0.660)、NLR(r=0.743)与房颤症状严重程度呈正相关(均P<0.05)。结论RDW、Gal-3、NLR与冠心病并发房颤有关,并与房颤患者症状严重程度有关,联合检测可作为评估患者并发房颤的标志物,为临床诊疗提供参考依据。

Objective To investigate the relationship between red blood cell distribution width(RDW),galactose lectin 3(Gal-3),neutrophil lymphocyte ratio(NLR)and coronary artery fibrillation(AF)complicated by coronary artery disease and its predictive value.Methods A two-center prospective study was conducted by selecting 134 patients with coronary artery disease without atrial fibrillation(coronary artery disease group)and 134 patients with coronary artery disease complicated by atrial fibrillation(atrial fibrillation group)in Chengde City Central Hospital hospital from February 2020 to March 2022,comparing the levels of RDW,Gal-3,and NLR in the two groups,analyzing the influencing factors related to coronary artery disease complicated by atrial fibrillation using logistic regression,analyzing the value of RDW,Gal-3,NLR and the combination of the three to assess atrial fibrillation using subject operating characteristic curve(ROC),and applying Spearman analysis of the relationship between RDW,Gal-3,and NLR and the severity of atrial fibrillation symptoms.Results RDW was(13.59±0.76)%,Gal-3 was(57.23±15.08)pg/ml,and NLR was(2.87±0.51)in the atrial fibrillation group,which were higher than(12.46±0.88)%,(49.66±11.95)pg/ml,and(2.19±0.67)in the coronary artery disease group(P<0.05).After correcting for the duration of coronary artery disease and CCS angina classification,RDW,Gal-3,and NLR were still significantly associated with coronary artery disease complicated by atrial fibrillation(P<0.05).The AUCs for RDW,Gal-3,NLR,and all three combined to assess coronary artery disease complicated by atrial fibrillation were 0.746,0.750,0.729,and 0.912,respectively;RDW(r=0.750),Gal-3(r=0.660),and NLR(r=0.743)were positively correlated with the severity of atrial fibrillation symptoms(all P<0.05).Conclusion RDW,Gal-3,and NLR are associated with coronary artery disease complicated by atrial fibrillation and with the severity of symptoms in patients with atrial fibrillation,and the combined test can be used as a marker to assess patients with complicated atrial fibrillation and provide a reference basis for clinical diagnosis and treatment.