摘要
目的探讨γ-谷氨酰转移酶/高密度脂蛋白胆固醇比率(gamma-glutamyl transferase/high-density lipoprotein cholesterol ratio,GHR)、中性粒细胞/淋巴细胞比率(neutrophil/lymphocyte ratio,NLR)与冠心病的关系及对冠心病的致病风险及预测价值。方法采用病例对照研究方法,连续入选2017年12月至2018年12月于承德医学院附属医院行冠状动脉造影的患者694例,依据冠状动脉造影结果将患者分为冠心病组(n=527)和non-冠心病组(n=167),记录所有患者的临床资料,γ-谷氨酰转移酶(gamma-glutamyl transferase,GGT)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)等生化检测指标,中性粒细胞、淋巴细胞计数等血液学指标,计算患者的GHR、NLR及Gensini评分。比较两组患者的临床基线资料、GHR、NLR等指标;受试者工作特征曲线(receiver operating characteristic curve,ROC)评估GHR、NLR对T2DM合并冠心病的诊断价值,并确定最佳临界值;Logistic回归分析冠心病的危险因素;Spearman相关性分析GHR、NLR与冠心病患者Gensini评分的相关性。结果冠心病组GHR、NLR分别为32.59(21.05,48.24)、3.53(2.18,8.46)均明显高于non-冠心病组16.56(10.07,25.21)、2.20(1.45,3.28),差异有统计学意义(Z值分别为11.094、9.055,P<0.05);ROC曲线分析显示,GHR、NLR诊断冠心病的曲线下面积(area under the curve,AUC)分别为0.785和0.732(P<0.05),当GHR、NLR分别取临界值19.805、2.678时,诊断冠心病效能最高,诊断敏感度、特异度分别为79.30%、62.90%和63.80%、68.30%,GGT诊断冠心病的AUC为0.628,临界值为19.500时,敏感度为80.50%,特异度为39.50%;GHR的AUC>GGT的AUC(Z=12.973,P<0.05);多因素Logistic回归分析显示,吸烟(OR=2.887,95%CI:1.850~4.505,P<0.05)、高血压(OR=2.009,95%CI:1.311~3.080,P<0.05)、空腹血糖(OR=1.109,95%CI:1.034~1.189,P<0.05)、年龄≥60岁(OR=1.567,95%CI:1.179~2.415,P<0.05)、NLR≥2.687(OR=3.152,95%CI:2.066~4.808,P<0.05)、GHR≥19.805(OR=4.768,95%CI:3.131~7.262,P<
Objective To investigate the correlation between gamma-glutamyl transferase/high-density lipoprotein cholesterol ratio(GHR),neutrophil/lymphocyte ratio(NLR)and coronary heart disease(CHD),and evaluated its pathogenic risk and predictive value for CHD.Methods A total of 694 patients admitted to our hospital from December 2017 to December 2018 for suspected CHD and coronary angiography were selected.According to the results of coronary angiography,the patients were divided into CHD group(n=527)and non-CHD group(n=167).The clinical data of all patients were recorded.Gamma-glutamyl transferase(GGT),high-density lipoprotein cholesterol(HDL-C)and other biochemical indicators were recorded.Neutrophils,lymphocyte count and other hematological indicators were recorded.GHR,NLR and Gensini scores of the patients were calculated.Clinical data and GHR,NLR and other indicators were compared between the two groups.Receiver operating characteristic curve(ROC)was used to evaluate the predictive value of GHR,NLR in CHD,and to determine the optimal cut-off value;Logstic regression analysis was used to investigate the risk factors of CHD.Spearman correlation analysis was used to analyze the correlation between serum OPN,OPG and Gensini score in patients with CHD.Results The GHR and NLR were 32.59(21.05,48.24)and 3.53(2.18,8.46)significantly higher in the CHD group than in the non-CHD group 16.56(10.07,25.21)and 2.20(1.45,3.28)respectively,with statistically significant differences(Z=11.094,9.055,P<0.05).ROC curve analysis showed that the AUC of NLR and MLR in diagnosing CHD was 0.785 and 0.732(P<0.05).When the critical values of GHR and NLR respectively were 19.805 and 2.678,respectively,the diagnostic efficiency of CHD was the highest,and the sensitivity and specificity were 79.30%,62.90%and 63.80%,68.30%,and the AUC of GGT in diagnosing CHD was 0.628.When the critical value was 19.500,the sensitivity and specificity were 80.50%and 39.50%,respectively,the AUC of GHR was greater than that of GGT(Z=12.973,P<0.05).Multivariate Logisti
作者
王亚柱
郭云飞
张英
单伟超
孙王乐贤
史菲
张皓然
薛文平
Wang Yazhu;Guo Yunfei;Zhang Ying;Shan Weichao;Sun Wanglexian;Shi Fei;Zhang Haoran;Xue Wenping(Department of Cardiology,The Affiliated Hospital of Chengde Medical College,Chengde 067000,China;Department of Anesthesiology,The Affiliated Hospital of Chengde Medical College,Chengde 067000,China)
出处
《中国综合临床》
2021年第6期488-495,共8页
Clinical Medicine of China
基金
河北省科技计划项目(17277769D)。
关键词
冠心病
Γ-谷氨酰转移酶
高密度脂蛋白胆固醇
中性粒细胞/淋巴细胞比值
危险因素
诊断
Coronary heart disease
Gamma-glutamyl transferase
High density lipoprotein cholesterol
Neutrophil/lymphocyte ratio
Influencing factors
Diagnosis
