肌酐和胱抑素C比值及单核细胞和高密度脂蛋白胆固醇比值与高血压合并冠心病的关系

Relationship of creatinine/cystatin C ratio and monocyte/HDL-C ratio with hypertension complicated with coronary heart disease

目的 探讨高血压合并冠心病与血清肌酐(creatinine, Cr)/胱抑素C(cystatin C,Cys C)比值及单核细胞/高密度脂蛋白胆固醇(high density lipoprotein-cholesterol, HDL-C)比值之间的相关性。方法 选取2021年8月至2023年8月于芜湖市第一人民医院就诊的高血压合并冠心病患者200例为观察组,选取同期于芜湖市第一人民医院就诊的高血压患者100例为对照组。200例观察组患者中,根据血管病变支数分为单支病变组104例、双支病变组75例及多支病变组21例;根据Gensini评分标准分为轻度狭窄组98例(<30分)、中度狭窄组78例(30~90分)及重度狭窄组24例(>90分)。收集受试者空腹静脉血,检测受试者血清Cys C、Cr、HDL-C及单核细胞水平,用Spearman相关性分析血清Cr/Cys C比值和单核细胞/HDL-C比值与冠状动脉病变支数及其冠状动脉病变严重程度的相关性。结果 观察组Cr、Cys C、单核细胞、单核细胞/HDL-C比值显著高于对照组,Cr/Cys C比值、HDL-C显著低于对照组(P<0.01)。多支病变组Cr、Cys C、单核细胞、单核细胞/HDL-C比值显著高于单支病变组和双支病变组,Cr/Cys C比值、HDL-C显著低于单支病变组和双支病变组(P<0.05)。重度狭窄组Cr、Cys C、单核细胞、单核细胞/HDL-C比值显著高于轻度狭窄组和中度狭窄组,Cr/Cys C比值、HDL-C显著低于轻度狭窄组和中度狭窄组(P<0.05)。Spearman相关性分析显示,Cr/Cys C比值与冠状动脉病变支数、冠状动脉狭窄程度呈负相关(r=-0.743,P<0.05;r=-0.673,P<0.05);单核细胞/HDL-C比值与冠状动脉病变支数、冠状动脉狭窄程度呈正相关(r=0.692,P<0.05;r=0.611,P<0.05)。结论 血清Cr/Cys C比值及单核细胞/HDL-C比值与高血压合并冠心病密切相关,且Cr/Cys C比值与病变严重程度呈显著负相关,单核细胞/HDL-C比值与病变严重程度呈显著正相关。

Objective To analyze the correlation of serum creatinine(Cr)/eystatin C(Cys C)ratio and monocyte/high density lipoprotein cholesterol(HDL C)ratio with hypertension complicated with coronary heart disease(CHD).Methods A total of 200 hypertension patients with concomi-tant CHD admitted in our hospital from August 2021 to August 2023 were recruited and served as the observation group.and another 100 patients with hypertension during the same period served as the control group.Based on the number of vascular lesions,the patients in the observation group were divided into single-,double-and multi-vessel disease subgroups(104,75 and 21 cases).According to their Gensini score(<30,30-90,>90),they were also assigned into mild,moderate and severe stenosis subgroup(98.78 and 24 cases).After the fasting venous blood sam-ples were harvested from all subjects,the serum levels of Cys C,Cr and HDL C were measured,and monocyte count was calculated,and Spearman correlation analysis was used to determine the correlation of serum Cr/Cys C ratio and monocyte/HDL C ratio with number and severity of cor-onary artery lesions.Results The observation group had significantly higher Cr and Cys C levels,monocyte count and monocyte/HDL C ratio,while lower Cr/Cys C ratio and HDLC level than the control group(P<0.01).The conditions of above indicators were more severe in the multi-vessel lesion subgroup than the single-and double-vessel lesion subgroups(P<0.05).Similar re-sults were observed in the severe stenosis subgroup when compared with the mild and moderate.stenosis subgroups(P<0.05).Spearman correlation analysis showed that the Cr/Cys C ratio was negatively correlated with the number of coronary artery lesions and the severity of coronary ar tery stenosis(r=-0.743,P<0.05;r=-0.673,P<0.05),and the monocyte/HDL-C ratio was positively correlated with the number of coronary artery lesions and the degree of coronary artery stenosis(r=0.692,P<0.05;r=0.611,P<0.05).Conclusion The serum Cr/Cys C ratio and monocyte/HDLC ratio are closely associated with hypertension combined with concomitant CHD.And the Cr/Cys C ratio is negatively correlated with the severity of the disease,and the.monocyte/HDL-C ratio is positively correlated with the severity of the disease in the patients.