摘要
目的探讨2型糖尿病合并冠心病患者中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)与冠状动脉病变程度的关系。方法选取2015年6月至2016年7月于扬州大学附属医院心内科就诊的144例2型糖尿病合并冠心病患者,冠脉病变程度根据Gensini积分将患者分为高危组(Gensini积分≥64分)75例、中低危组(Gensini积分<64分)69例。比较不同组别患者一般资料、实验室检查指标;采用多因素Logistic回归方法分析患者冠状动脉病变程度的影响因素;PLR、NLR与患者Gensini积分的相关性分析采用Pearson相关分析;绘制ROC曲线以评价PLR、NLR对患者高危冠状动脉复杂病变的预测价值。结果不同程度的冠状动脉病变组体质量指数(BMI)、收缩压(SBP)、糖化血红蛋白(HbA1c)、NLR、PLR之间差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,脂蛋白a、NLR、PLR为冠状动脉病变程度的独立危险因素(P<0.05)。相关性分析显示,冠状动脉病变程度与NLR、PLR呈正相关关系(r=0.386,P<0.001;r=0.487,P<0.001)。NLR预测2型糖尿病合并冠心病患者高危冠状动脉复杂病变的曲线下面积为0.843,95%CI 0.78~0.907,最佳截断值为2.566,敏感度为82.6%,特异度为73.3%;PLR曲线下面积为0.72,95%CI0.778~0.909,最佳截断值为107.054,敏感度为84.1%,特异度为78.7%。结论NLR、PLR是2型糖尿病合并冠心病患者的独立危险因素,与患者的Gensini积分呈正相关。NLR、PLR可作为预测2型糖尿病合并冠心病患者冠状动脉病变严重程度的经济且易测的实验室指标。
Objective To investigate the relationship of platelet-lymphocyte ratio(PLR)and neutrophil-lymphocyte ratio(NLR)with the degree of atherosclerosis in patients with type 2 diabetes mellitus(T2DM)and coronary artery disease(CAD).Methods A total of 144 diabetic patients with CAD who visited the Department of Cardiology,Affiliated Hospital of Yangzhou University from June 2015 to July 2016 were selected.According to the degree of CAD,the patients were divided into a high-risk group(Gensini score≥64 points)and a medium-low risk group(Gensini score<64 points).The general data and laboratory indexes were compared between groups.Multivariable Logistic regression analysis was performed to identify the factors influencing the degree of CAD.Correlation of PLR and NLR with Gensini score was assessed using Pearson correlation analysis.ROC curve analysis was performed to evaluate the value of PLR and NLR in predicting complex coronary artery lesions in patients with type 2 diabetes.Results There were statistically significant differences in body mass index,systolic blood pressure,hemoglobin A1c,NLR,and PLR between the two groups of patients with different degrees of CAD(P<0.05).Multivariate Logistic regression analysis showed that lipoprotein a,NLR,and PLR were independent risk factors for the degree of CAD(P<0.05).The degree of coronary artery lesions in diabetic patients with CAD was positively correlated with NLR and PLR(r=0.386,P<0.001;r=0.487,P<0.001).The area under the NLR curve was 0.843(95%CI:0.780-0.907),with the best cutoff value of 2.566,the sensitivity was 82.6%,and the specificity was 73.3%.The area under the PLR curve was 0.72(95%CI:0.778-0.909),with the best cutoff value of 107.054,the sensitivity was 84.1%,and the specificity was 78.7%.Conclusion NLR and PLR are independent risk factors for patients with type 2 diabetes mellitus complicated with CAD.NLR and PLR are positively correlated with Gensini score in patients with type 2 diabetes mellitus complicated with CAD.NLR and PLR can be used as economic and eas
作者
郭姣姣
龚开政
Guo Jiaojiao;Gong Kaizheng(Medical College of Yangzhou University,Yangzhou 225000,China;Department of Cardiology,Affiliated Hospital of Yangzhou University,Yangzhou 225000,China)
出处
《中华临床医师杂志（电子版）》
CAS
北大核心
2021年第3期171-176,共6页
Chinese Journal of Clinicians(Electronic Edition)
基金
国家自然科学基金资助项目(81770262)。
