中性粒细胞百分比/白蛋白比值与冠心病合并糖尿病的相关性分析

Correlation Analysis Between Neutrophil Percentage-to-albumin Ratio and Coronary Heart Disease Complicated with Diabetes Mellitus

目的探讨中性粒细胞百分比/白蛋白比值(NPAR)与冠心病(CAD)合并糖尿病的关系。方法纳入2016年1月-2018年12月于平泉市医院住院且行冠状动脉造影术的686例CAD患者为研究对象。根据是否合并2型糖尿病(T2DM)将患者分为CAD组(n=373)、CAD+T2DM组(n=313)。另将CAD+T2DM组根据Gensini评分三分位数分为低Gensini评分组(Gensini评分≤7分),中Gensini评分组(Gensini评分8~16分),高Gensini评分组(Gensini评分≥17分)3组。比较CAD组与CAD+T2DM组临床资料,并比较不同Gensini评分三分位数组NPAR,另分析NPAR与Gensini评分的关系,以及其预测CAD+T2DM的效能。结果CAD组与CAD+T2DM组年龄、WBC、BUN、NEUT、HDL、Gensini评分、NPNR值比较,差异有统计学意义(P<0.05),而两组其余指标比较,差异无统计学意义(P>0.05);高Gensini评分组NPAR水平高于低、中Gensini评分组(P<0.05);而低Gensini评分NPAR水平与中Gensini评分组比较,差异无统计学意义(P>0.05);ROC曲线分析显示,NPAR预测CAD+T2DM的ROC曲线下面积为0.633(95%CI:0.591~0.675,P<0.05),约登指数为0.29,敏感性为57.20%,特异性为71.80%,最佳截断点1.4765;Spearman秩相关分析显示,NPAR与Gensini评分呈正相关(P<0.05)。结论NPAR与CAD合并T2DM密切相关,NPAR在诊断冠心病合并糖尿病中有临床应用价值。

Objective To investigate the relationship between neutrophil percentage-to-albumin ratio(NPAR)and coronary heart disease(CAD)complicated with diabetes mellitus.Methods A total of 686 CAD patients who were hospitalized in Pingquan Hospital from January 2016 to December 2018 and underwent coronary angiography were included in the study.The patients were divided into CAD group(n=373)and CAD+T2DM group(n=313)according to whether they had type 2 diabetes mellitus(T2DM).In addition,the CAD+T2DM group was divided into low Gensini score group(Gensini score≤7 scores),medium Gensini score group(Gensini score 8-16 scores)and high Gensini score group(Gensini score≥17 scores)according to the Gensini score tertile.The clinical data of CAD group and CAD+T2DM group were compared,and the NPAR of different Gensini score tertiles was compared.The relationship between NPAR and Gensini score and its efficacy in predicting CAD+T2DM were analyzed.Results There were significant differences in age,WBC,BUN,NEUT,HDL,Gensini score and NPNR between CAD group and CAD+T2DM group(P<0.05),there was no significant difference in the other indexes between the two groups(P>0.05).The NPAR level in the high Gensini score group was higher than that in the low and medium Gensini score groups(P<0.05),while there was no significant difference in NPAR level between the low Gensini score group and the middle Gensini score group(P>0.05).ROC curve analysis showed that the area under the ROC curve of NPAR in predicting CAD+T2DM was 0.633(95%CI:0.591-0.675,P<0.05),the Youden index was 0.29,the sensitivity was 57.20%,the specificity was 71.80%,and the best cut-off point was 1.4765.Spearman rank correlation analysis showed that NPAR was positively correlated with Gensini score(P<0.05).Conclusion NPAR is closely related to CAD combined with T2DM,and NPAR has clinical application value in the diagnosis of coronary heart disease combined with diabetes mellitus.