中性粒细胞计数和中性粒细胞与淋巴细胞比值对糖尿病患者冠状动脉病变程度的预测价值

Predictive value of neutrophil count and neutrophil-to-lymphocyte ratio for coronary artery disease degree in diabetic patients

目的:分析中性粒细胞计数和中性粒细胞与淋巴细胞比值(NLR)对糖尿病患者冠状动脉病变程度的预测价值。方法:回顾性分析2021年9月至2022年4月于本院心内科住院行冠脉造影的糖尿病患者287例的临床资料。根据冠脉造影结果分为冠脉正常组94例,轻中度病变组(0<Gensini积分≤40分)102例、重度病变组(Gensini积分>40分)91例。比较三组患者的中性粒细胞计数和NLR。采用ROC曲线分析中性粒细胞计数和NLR对糖尿病患者冠状动脉病变程度的预测价值。结果:与冠脉正常组相比,轻中度病变和重度病变组的中性粒细胞计数[4.17(3.31,4.88)×10^(9)/L比4.96(4.28,6.07)×10^(9)/L比5.57(4.62,7.03)×10^(9)/L]、NLR[2.25(1.74,2.72)比3.18(2.48,3.66)比3.49(3.03,4.32)]均显著增加(P均<0.001)。二元Logistic回归分析显示,中性粒细胞计数(OR=1.566,P<0.001)、NLR(OR=2.152,P<0.001)是糖尿病患者冠脉病变的独立危险因素。ROC结果提示,中性粒细胞计数[曲线下面积(AUC)=0.750]、NLR(AUC=0.775)对糖尿病患者冠状动脉病变程度具有较好的预测价值。结论:糖尿病患者中性粒细胞计数、NLR与冠脉狭窄程度有着密切联系,均有较好的预测价值。

Objective:To analyze the predictive value of neutrophil count and neutrophil-to-lymphocyte ratio(NLR)for severity of coronary artery lesions in diabetic patients.Methods:Clinical data of 287 diabetic patients who admitted to our Department of Cardiology and received coronary angiography(CAG)from September 2021 to April 2022 were retrospectively analyzed.According to CAG results,they were divided into normal coronary group(n=94),mild-moderate disease group(0<Gensini score≤40 points,n=102)and severe disease group(Gensini score>40 points,n=91).Neutrophil count and NLR were compared among three groups.ROC curve was used to analyze the predictive value of neutrophil count and NLR for severity of coronary artery disease in diabetic patients.Results:Compared with normal coronary group,there were significant rise in neutrophil count[4.17(3.31,4.88)×10^(9)/L vs.4.96(4.28,6.07)×10^(9)/L vs.5.57(4.62,7.03)×10^(9)/L]and NLR[2.25(1.74,2.72)vs.3.18(2.48,3.66)vs.3.49(3.03,4.32)]in mild-moderate disease group and severe disease group(P<0.001 all).Binary Logistic regression analysis indicated that neutrophil count(OR=1.566,P<0.001)and NLR(OR=2.152,P<0.001)were independent risk factors for coronary disease in diabetic patients.ROC indicated that neutrophil count[area under the curve(AUC)=0.750]and NLR(AUC=0.775)possessed good predictive value for severity of coronary artery disease in diabetic patients.Conclusion:Neutrophil count and NLR are closely associated with coronary artery disease degree in diabetic patients,which possess good predictive value.