中性粒细胞计数与高密度脂蛋白胆固醇比值与早发冠心病的相关性分析

Correlation Between Neutrophil to High - density Lipoprotein Cholesterol Ratio and Premature Coronary Heart Disease

目的探讨中性粒细胞计数与高密度脂蛋白胆固醇比值(neutrophil to high-density lipoprotein cholesterol ratio,NHR)与早发冠心病的相关性。方法收集2021年10月~2022年3月于华北理工大学附属医院心内科住院且首次行冠状动脉造影的139例患者(男性≤55岁,女性≤65岁)的临床资料。根据冠状动脉造影结果,将研究对象分为早发冠心病组(n=87)和非冠心病组(n=52)。比较两组患者的基线资料、血常规和血脂指标。运用多因素Logistic回归分析评价增加早发冠心病发病风险的因素,应用Spearman相关性分析评价NHR与冠状动脉血管狭窄程度(Gensini积分)的相关性,绘制受试者工作特征(receiver operating characteristic,ROC)曲线,分析中性粒细胞计数、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)和NHR对早发冠心病的预测价值。结果早发冠心病组患者的空腹血糖水平、Gensini积分高于非冠心病组,高血压、糖尿病占比高于非冠心病组(P<0.05)。早发冠心病组患者的白细胞计数、单核细胞计数、中性粒细胞计数、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)及NHR水平高于非冠心病组(P<0.05)。多因素Logistic回归分析结果显示,NHR水平升高可增加早发冠心病的发病风险,NHR每增加1,早发冠心病发病风险增加50%(OR=1.50,95%CI:1.06~2.14,P=0.02)。Spearman相关性分析结果显示,NHR与Gensini积分呈正相关(r=0.18,P=0.03)。中性粒细胞计数、NHR对应的曲线下面积(area under the curve,AUC)分别为0.61(95%CI:0.51~0.71,P=0.03)、0.64(95%CI:0.54~0.74,P<0.01)。结论NHR水平升高可增加早发冠心病的发病风险,且与冠状动脉狭窄程度呈正相关,并对早发冠心病有一定的预测价值。

Objective To investigat the correlation between neutrophil to high-density lipoprotein cholesterol ratio(NHR)and premature coronary heart disease.Methods The clinical data of 139 patients(male≤55 years old,female≤65 years old)admitted to the Department of Cardiology,Affiliated Hospital of North China University of Science and Technology from October 2021 to March 2022 who underwent coronary angiography for the first time were collected.According to the results of coronary angiography,the subjects were divided into premature coronary heart disease group(n=87)and non-coronary heart disease group(n=52).The baseline data,blood routine and blood lipid indexes between the two groups were compared.Multivariate Logistic regression analysis was used to evaluate the factors that increase the risk of premature coronary heart disease,and Spearman correlation analysis was used to analyze the correlation between NHR and the degree of coronary artery stenosis(Gensini score).The receiver operating characteristic(ROC)curve was used to analyze the predictive value of neutrophils,high density lipoprotein cholesterol(HDL-C)and NHR in the diagnosis of premature coronary heart disease.Results The levels of fasting blood glucose and Gensini score in the premature coronary heart disease group were higher than those in the non-coronary heart disease group,and the proportions of hypertension and diabetes were higher than those in the non-coronary heart disease group(P<0.05).The levels of white blood cells,monocytes,neutrophils,low-density lipoprotein cholesterol(LDL-C)and NHR in the premature coronary heart disease group were higher than those in the non-coronary heart disease group(P<0.05).Multivariate Logistic regression analysis showed that the increase of NHR level could increase the risk of premature coronary heart disease.When NHR increased by 1,the risk of premature coronary heart disease increased by 50%(OR=1.50,95%CI:1.06-2.14,P=0.02).Spearman correlation analysis showed that NHR was positively correlated with Gensini score(r=0.18,P=0.03).The area under the curve(AUC)of neutrophils and NHR were 0.61(95%CI:0.51-0.71,P=0.03)and 0.64(95%CI:0.54-0.74,P<0.01).Conclusion n High level of NHR can increase the risk of premature coronary heart disease,and was positively correlated with the severity of coronary artery stenosis,and has a certain predictive value for the diagnosis of premature coronary heart disease.