血小板参数联合中性粒细胞/淋巴细胞比值与急性冠脉综合征患者冠状动脉病变程度的相关性

Correlation of the degree of coronary lesions with platelet parameters and NLR in patients with ACS

目的分析血小板参数和中性粒细胞与淋巴细胞比值(NLR)与急性冠脉综合征(ACS)患者冠状动脉病变程度的相关性。方法选取2021年l月至2022年3月于合肥市第一人民医院心内科就诊的ACS患者237例,分为不稳定型心绞痛组(n=122)、急性心肌梗死组(n=115);选择同时期冠脉造影阴性的患者作为对照组(n=88)。依据Gensini评分将ACS患者分为低评分组(n=80)、中评分组(n=80)及高评分组(n=77)。比较上述组间临床资料的差异,运用多因素logistic回归及ROC曲线评估血小板参数联合NLR以对ACS的发病及冠状动脉病变严重程度的预测价值。结果平均血小板体积(MPV)、血小板分布宽度(PDW)、NLR与Gensini评分及冠状动脉病变支数呈正相关;多因素logistic回归分析显示,PDW、NLR及高血压是ACS发病的独立危险因素;ROC曲线分析显示,MPV、PDW、NLR三者联合对冠状动脉病变的严重程度具有更高的预测价值,曲线下面积为0.830(95%CI:0.777~0.883,P<0.05)。结论血小板参数、NLR与Gensini评分及冠状动脉病变支数之间存在显著的相关性,对ACS的发病及冠状动脉病变的严重程度有一定预测价值。

Objective To analyze the correlation of the degree of coronary lesions with platelet parameters and neutrophil-to-lymphocyte ratio(NLR)in patients with acute coronary syndrome(ACS).Methods A total of 237 patients with ACS who attended the Department of Cardiology of Hefei First People’s Hospital from January 2021 to March 2022 were selected and divided into an unstable angina group(n=122)and an acute myocardial infarction group(n=115).And patients with negative coronary angiogram in the same period were included in a control group(n=88).Patients with ACS were divided into a low-score group(n=80),medium-score group(n=80)and high-score group(n=77)according to Gensini scores.These groups were compared for differences in clinical data,and multifactorial logistic regression and receiver operating characteristic(ROC)curves were used to assess the value of platelet parameters plus NLR for predicating the onset of ACS and the severity of coronary lesions.Results Mean platelet volume(MPV),platelet distribution width(PDW)and NLR were positively correlated with Gensini scores and number of coronary arteries with lesions.Multifactorial logistic regression analysis showed that PDW,NLR and hypertension were independent risk factors for the onset of ACS.ROC curve analysis showed that the combination of MPV,PDW and NLR had a higher value for predicting the severity of coronary lesions,with an area under the ROC curve of 0.830(95%CI:0.777-0.883,P<0.05).Conclusion There is a significant correlation between platelet parameters,NLR,Gensini scores,and the number of coronary arteries with lesions,which is of great value in predicting the onset of ACS and the severity of coronary artery lesions.