MHR对原发性高血压患者左心房扩大的预测价值

Predictive value of MHR in left atrial enlargement in patients with primary hypertension

目的分析单核细胞与高密度脂蛋白胆固醇比值(MHR)对原发性高血压(PHT)患者左心房扩大(LAE)的预测价值。方法回顾性选取本院PHT患者112例作为PHT组,健康体检者94例为对照组。根据是否发生LAE,将PHT组患者分为LAE组和非LAE组。比较对照组与PHT组、LAE组与非LAE组的临床资料、血常规、生化指标。采用胸部超声心动图计算左心房容积(LAV)、左心房容积指数(LAVI)。采用多因素Logistic回归分析PHT患者发生LAE的危险因素;采用Pearson相关性分析各项指标与PHT患者发生LAE的相关性;采用ROC分析MHR对PHT患者发生LAE的预测价值。结果与对照组比较,PHT组年龄、血压、体质指数、白细胞、中性粒细胞、单核细胞、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)、体表面积(BSA)、LAV、LAVI和MHR升高(P<0.05)。与非LAE组比较,LAE组PHT患者MHR、单核细胞、LDLC升高、而高密度脂蛋白胆固醇(HDLC)降低(P<0.05)。多因素Logistic回归分析结果显示,年龄、MHR、HDLC、LDLC、白细胞、单核细胞均是PHT发生LAE的危险因素。相关性分析结果显示,MHR与年龄、BSA、白细胞、LAV和LAVI呈正相关(P<0.05),与TC、TG和HDLC呈负相关(P<0.05)。ROC结果显示,MHR cut-off值为0.42时,MHR对PHT发生LAE的预测价值较高。结论MHR对PHT患者左心房扩大的发生具有较高的预测价值,有作为独立预测因子的潜力。

Aim To explore the predictive value of monocyte to high density lipoprotein cholesterol ratio(MHR)for left atrial enlargement in patients with primary hypertension(PHT).Methods 112 PHT patients in our hospital and 94 healthy individuals were retrospectively selected as the PHT group and the control group respectively.According to whether LAE has occurred,PHT patients were divided into LAE group and non-LAE group.The clinical data,blood routine and biochemical indexes of control group and PHT group(including LAE group and non-LAE group)were compared.Left atrial volume(LAV)and left atrial volume index(LAVI)were calculated by chest echocardiography.Multivariate Logistic regression was used to analyze the risk factors of LAE in PHT patients,Pearson correlation was used to analyze the correlation between various indexes and LAE in PHT patients,and ROC curve was used to analyze the predictive value of MHR for LAE in primary PHT patients.Results Compared with the control group,the age,blood pressure,body mass index,white blood cell,neutrophil,monocyte,total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDLC),body surface area(BSA),LAV,LAVI,and MHR in the PHT group were increased(P<0.05).Compared with the non-LAE group,the MHR,monocyte,low density lipoprotein cholesterol(LDLC)of PHT patients in the LAE group were significantly higher,while high density lipoprotein cholesterol(HDLC)was decreased(P<0.05).The results of multivariate Logistic regression analysis showed that age,MHR,HDLC,LDLC,white blood cell,and monocyte were all risk factors for LAE in PHT.The correlation analysis results showed that MHR was positively correlated with age,BSA,white blood cell,LAV,and LAVI(P<0.05),and negatively correlated with TC,TG,and HDLC(P<0.05).The ROC curve results show that when the cut-off value is 0.42,MHR has good predictive value for LAE in PHT.Conclusion MHR has high predictive value for the occurrence of left atrial enlargement in PHT patients and has the potential as an independent predictor.