摘要
目的研究冠心病(CHD)患者血小板(PLT)与淋巴细胞(LYM)比值(PLR)与冠脉斑块稳定性的关系。方法选取2016年1月~2019年1月安徽省第二人民医院(以下简称"我院")收治的292例CHD患者作为CHD组,根据斑块性质分为易损斑块组(155例)和稳定斑块组(137例),另选取同期于我院行健康体检的志愿者150名为对照组。测定各组血细胞分析和血压、血糖、血脂、肝肾功等生化指标。采用logistic回归分析CHD患者易损斑块的危险因素,采用ROC曲线分析法评估各指标的诊断价值。结果稳定斑块组的体重指数(BMI)、高血压病及糖尿病百分比、C反应蛋白(CRP)、血肌酐(Scr)、尿素氮(BUN)、PLT和PLR均高于对照组,LYM低于对照组,差异有统计学意义(P<0.05);易损斑块组的BMI、高血压病及糖尿病百分比、CRP、Scr、BUN、纤维蛋白原(FIB)和PLR均高于稳定斑块组及对照组,三酰甘油、低密度脂蛋白胆固醇、总胆固醇、丙氨酸氨基转移酶、白细胞、PLT均高于对照组,LYM低于对照组,差异有统计学意义(P<0.05)。多因素logistic回归分析显示:PLR(OR=3.320,95%CI:1.622~6.795,P=0.001)、CRP(OR=2.380,95%CI:1.292~4.384,P=0.005)、FIB(OR=1.862,95%CI:1.117~3.105,P=0.017)均是CHD斑块不稳定的独立危险因素。三者联合应用诊断CHD患者冠脉斑块稳定性的敏感度、特异度分别为0.916、0.891。结论PLR在CHD患者中明显升高,是影响冠脉斑块稳定性的一个独立危险因素,关注PLR可指导临床诊治。
Objective To study the relationship between platelet(PLT)to lymphocyte(LYM)ratio(PLR)and coronary plaque stability in patients with coronary heart disease(CHD).Methods Two hundred and ninety-two patients with CHD admitted to the Second People′s Hospital of Anhui Province("our hospital"for short)from January 2016 to January 2019 were selected as CHD group.According to the characteristics of plaque,they were divided into vulnerable plaque group(155 cases)and stable plaque group(137 cases).One hundred and fifty volunteers who took physical examination in our hospital during the same period were selected as control group.Blood cell analysis,blood pressure,blood glucose,blood lipid,liver and kidney function between groups were measured.The risk factors of vulnerable plaque in CHD patients were analyzed by logistic regression,and the diagnostic value of each index was evaluated by ROC curve analysis.Results The body mass index(BMI),the percentage of hypertension and diabetes,C-reactive protein(CRP),serum creatinine(Scr),urea nitrogen(BUN),PLT and PLR in stable plaque group were higher than those in control group,and LYM was lower than that in control group,with statistically significant differences(P<0.05).BMI,percentage of hypertension and diabetes,CRP,Scr,BUN,FIB and PLR in vulnerable plaque group were higher than those in stable plaque group and control group,triglycerides,LDL cholesterol,total cholesterol,alanine aminotransferase,leukocytes and PLT in vulnerable plaque group were higher than those in control group,LYM of vulnerable plaque group was lower than that of control group,with statistically significant differences(P<0.05).Multivariate logistic regression analysis showed that PLR(OR=3.320,95%CI:1.622-6.795,P=0.001),CRP(OR=2.380,95%CI:1.292-4.384,P=0.005),FIB(OR=1.862,95%CI:1.117-3.105,P=0.017)were independent risk factors for CHD plaque instability.The sensitivity and specificity of three methods in the diagnosis of CHD was 0.916 and 0.891 respectively.Conclusion PLR is significantly increased in CHD pati
作者
宋博凡
努热曼古丽·阿布都克热木
高彦琳
成威
SONG Bofan;Nuremanguli·Abudukeremu;GAO Yanlin;CHENG Wei(Ward One,Department of Cardiovascular Medicine,the Second People′s Hospital of Anhui Province,Anhui Province,Hefei 230041,China;Ward Two of Coronary Heart Disease,Department of Cardiovascular Medicine,the First People′s Hospital of Kashi Region,Xinjiang Uygur Autonomous Region,Kashi 844000,China)
出处
《中国医药导报》
CAS
2020年第20期54-57,84,共5页
China Medical Herald
基金
新疆维吾尔自治区自然科学基金资助项目(2016D01C118)。
关键词
血小板与淋巴细胞比值
冠心病
冠脉斑块
心血管不良事件
Platelet to lymphocyte ratio
Coronary heart disease
Coronary plaque
Cardiovascular adverse event
