中性粒细胞与血小板比值与早发冠心病相关性的临床研究

The correlation between neutrophil-to-platelet ratio and premature coronary heart disease

目的:评估中性粒细胞与血小板比值(neutrophil to lymphocyte ratio,NPR)与早发冠心病(premature coronary heart disease,PCHD)及冠状动脉(冠脉)病变程度的相关性。方法:入选于江苏省苏北人民医院住院并首次行冠脉造影检查者共980例(男性<55岁,女性<65岁),将入组患者分为早发冠心病组(PCHD组,648例)及非冠心病组(NCHD组,332例),并根据Gensini评分将PCHD组患者分为低分组(≤24分)和高分组(>24分),比较各组组间资料的差异性,并运用统计学软件进行统计分析。结果:(1)PCHD组NPR水平显著高于NCHD组(P<0.05),PCHD高分组NPR水平显著高于低分组(P<0.05)。(2)相关性分析中,NPR水平与Gensini评分呈正相关(r=0.602,P<0.001)。(3)多因素logistic回归分析显示,高血压病(OR=1.652,95%CI:1.157~2.360,P=0.006)、糖尿病(OR=2.196,95%CI:1.331~3.624,P=0.002)、饮酒史(OR=2.371,95%CI:1.394~4.034,P=0.001)、白细胞(OR=1.286,95%CI:1.064~1.554,P=0.009)及NPR(OR=4.224,95%CI:2.859~6.242,P<0.001)为PCHD患病的独立危险因素;性别(OR=2.105,95%CI:1.330~3.334,P=0.002)、吸烟史(OR=2.427,95%CI:1.545~3.812,P<0.001)、白细胞(OR=1.386,95%CI:1.155~1.663,P<0.001)及NPR(OR=2.389,95%CI:1.808~3.157,P<0.001)为PCHD重度冠脉病变的独立危险因素。(4)ROC曲线分析中,NPR对PCHD患病有一定的预测价值,曲线下面积(AUC)为0.832,截断值为1.630,灵敏度为0.978,特异度为0.497;NPR对PCHD重度病变具有一定的预测作用,AUC为0.790,截断值为2.522,灵敏度为0.716,特异度为0.719。结论:在PCHD患者中,NPR水平较高,且NPR越高,冠脉病变程度越重。NPR可在一定程度上预测PCHD的发生以及冠脉病变严重程度。

Objective:To evaluate the correlation between neutrophil to lymphocyte ratio(NPR) and premature coronary heart disease(PCHD) and the degree of coronary artery disease.Methods:A total of 980 patients(male<55 years old,female<65 years old) who were hospitalized in Northern Jiangsu People's Hospital of Jiangsu Province and underwent coronary angiography for the first time were selected.All enrolled patients were divided into the PCHD group(n=648) and the non-coronary heart disease group(NCHD group,n=332),and according to the Gensini score,patients in the PCHD group were divided into the low score group(≤24 points) and high score group(>24 points).Compare the differences in data between each group,and use statistical software for statistical analysis.Results:(1)The NPR level of the PCHD group was significantly higher than that of the NCHD group(P<0.05),and the NPR level of the high score group was higher than that of the low score group(P<0.05).(2)In the correlation analysis,the NPR level was positively correlated with the Gensini score(r=0.602,P<0.001).(3)Multifactor logistic correlation analysis showed that hypertension(OR=1.652,95%CI:1.157-2.360,P=0.006),diabetes(OR=2.196,95%CI:1.331-3.624,P=0.002),drinking history(OR=2.371,95%CI:1.394-4.034,P=0.001),white blood cells(OR=1.286,95%CI:1.064-1.554,P=0.009) and NPR(OR=4.224,95%CI:2.859-6.242,P<0.001) were independent risk factors for PCHD;Gender(OR=2.105,95%CI:1.330-3.334,P=0.002),smoking history(OR=2.427,95%CI:1.545-3.812,P<0.001),white blood cells(OR=1.386,95%CI:1.155-1.663,P<0.001),and NPR(OR=2.389,95%CI:1.808-3.157,P<0.001) were independent risk factors for severe coronary artery disease in PCHD.(4)In the ROC curve analysis,NPR had some values in predicting the prevalence of PCHD.The area under the ROC curve(AUC) was 0.832,the cutoff value was 1.630,the sensitivity was 0.978,and the specificity was 0.497.NPR also has some values in predicting the severe PCHD lesion,the AUC was 0.790,the cutoff value was 2.522,the sensitivity was 0.716,and the specificity was 0.719.Conclusion:In patients with PCHD,the level of NPR is high,and the higher the NPR,the more severe the coronary artery disease.NPR predicts the occurrence of PCHD and the severity of coronary artery lesions to a certain extent.