摘要
目的探讨单核细胞与高密度脂蛋白胆固醇比值(MHR)和冠状动脉狭窄程度的关系及MHR对冠心病的预测价值方法回顾性分析我院2013年3月至2018年6月行冠状动脉造影的患者1867例,其中非冠心病组385例、冠心病组1482例,比较两组患者MHR的差异;根据Gensini评分或SYNTAX评分进一步将冠心病组患者分为三个亚组(轻度病变组、中度病变组、重度病变组),比较三组间MHR的差异;使用Spearman相关分析法对MHR与冠状动脉狭窄程度进行相关性分析,多因素Logistic回归分析冠心病的独立危险因素,同时使用ROC曲线计算MHR对冠心病的预测价值。结果冠心病组MHR水平明显高于非冠心病组(0.53±0.30比0.40±0.20,P<0.001);冠心病三个亚组间比较显示冠状动脉病变程度越重,MHR水平越高,差异具有统计学意义(Gensini评分:0.48±0.24比0.52±0.33比0.59±0.31,P<0.001;SYNTAX评分:0.50±0.26比0.52±0.21比0.56±0.30,P<0.01)。Spearman相关分析显示,MHR水平与冠状动脉狭窄程度(Gensini评分:r=0.258,P<0.001;SYNTAX评分:r=0.216,P<0.001)呈正相关。多因素Logistic回归分析结果显示,年龄、吸烟、糖尿病、高血压、超敏C反应蛋白和MHR均可作为冠心病的独立危险因素。ROC曲线显示,当MHR诊断临界值取0.34时,其诊断冠心病的效能最高,灵敏度为77.1%,特异度为46.4%。结论MHR与冠心病的严重程度显著相关,可作为冠心病诊断和治疗评估的检测指标。
Objective To investigate the association between monocyte to high-density lipoprotein cholesterol ratio(MHR)and degree of coronary artery stenosis and then to evaluate the clinical value of MHR in predicting coronary artery disease(CAD).Methods A total of 1867 patients who underwent coronary angiography in our hospital from March 2013 to June 2018 were enrolled into this study and analyzed retrospectively.Among them,385 non-CAD hospitalized patients were selected as control group and 1482 patients diagnosed as CAD were classified into three subgroups(mild,moderate,severe)according to the tertiles of their Gensini score or SYNTAX score,the levels of MHR among the three subgroups were compared.The Spearman correlation was used to analyze the correlation between MHR and coronary stenosis;Logistic regression was used for analyzing independent risk factors of CAD;the ROC curve was used to evaluate the predictive value of MHR for coronary heart disease.Results The level of MHR was higher in CAD group compared with non-CAD group(0.53±0.30 vs.0.40±0.20,P<0.01).The difference of MHR among the three subgroups was statistically significant(Gensini score:0.48±0.24 vs.0.52±0.33 vs.0.59±0.31,P<0.001;SYNTAX score:0.50±0.26 vs.0.52±0.21 vs.0.56±0.30,P<0.01).The severer the coronary stenosis,the higher the MHR level.The Spearman correlation analysis showed that the level of MHR was significantly correlated with Gensini score(r=0.258,P<0.001)and SYNTAX score(r=0.216,P<0.001).In multivariate Logistic regression analysis,MHR was independent risk factor of CAD together with age,smoking,diabetes,hypertension and hypersensitive C-reactive protein.The ROC curve showed that the optimal cut off value of MHR in predicting CAD was 0.34 with sensitivity of 77.1%and specificity of 46.4%.Conclusion MHR is associated with the severity of coronary artery lesions and has a certain predictive value for CAD,which can be used as a biomarker for the diagnosis and evaluation of therapeutic effect of CAD.
作者
李亚
李曙
马于林
李佳玲
林明莹
万静
LI Ya;LI Shu;MA Yu-lin;LI Jia-Iing;LIN Ming-ying;WAN Jing(Department of Cardiology,Zhongnan Hospital,Wuhan University,Wuhan 430071,China)
出处
《中国心血管病研究》
CAS
2019年第12期1110-1114,共5页
Chinese Journal of Cardiovascular Research
基金
国家自然科学基金(81670409)~~
