单核细胞/淋巴细胞比值与非ST段抬高型心肌梗死严重程度及预后关系研究
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摘要
目的探讨单核细胞/淋巴细胞比值与非ST段抬高型心肌梗死严重程度及预后关系。方法选取2016年6月至2018年9月于新泰市人民医院行冠状动脉介入治疗且资料完整的NSTEMI患者220例,收集所有患者的临床资料,并进一步定期临床随访12个月,记录MACCE发生情况。采用SPSS20.0统计软件处理数据。结果 (1)外周血MLR水平与NSTEMI患者SYNTAX评分呈正相关(r=0.575,P<0.05);(2)多因素COX回归分析显示,MLR、年龄、2型糖尿病、高血压病是NSTEMI患者MACCE的独立预测因素;(3)ROC曲线分析结果显示,外周血MLR水平预测MACCE的曲线下面积为0.749(95%CI:0.701～0.791),最佳截断值为0.43,灵敏度为78.68%,特异度为71.71%。结论外周血MLR水平与NSTEMI患者冠状动脉病变严重程度呈正相关,且是NSTEMI患者MACCE的独立预测因素,在临床工作中可辅助细化NSTEMI患者危险分层管理。
Objective To investigate the relationship between the ratio of monocyte to lymphocyte and the severity and prognosis of non-ST-segment elevation myocardial infarction. Methods Two hundred and twenty patients with NSTEMI who underwent coronary intervention in Xintai People's Hospital from June 2016 to September 2018 were selected. The clinical data of all patients were collected and followed up regularly for 12 months to record the occurrence of MACCE. SPSS 20 statistical software was used to process data. Results(1) Peripheral bloodmLR level was positively correlated with SYNTAX score of NSTEMI patients(r=0.575, P<0.05);(2) Multivariate COX regression analysis showed thatmLR, age, type 2 diabetes mellitus and hypertension were independent predictors of MACCE in NSTEMI patients;(3) ROC curve analysis showed that the area under the curve of predicting MACCE bymLR level in peripheral blood was 0.749(95% CI: 0.701～0.791), the best truncation value was 0.43, the sensitivity was 78.68%, and the specificity was 71.71%. Conclusion The level ofmLR in peripheral blood is positively correlated with the severity of coronary artery disease in NSTEMI patients, and it is an independent predictor of MACCE in NSTEMI patients. It can help to refine the risk stratification management of NSTEMI patients in clinical work.
Objective To investigate the relationship between the ratio of monocyte to lymphocyte and the severity and prognosis of non-ST-segment elevation myocardial infarction. Methods Two hundred and twenty patients with NSTEMI who underwent coronary intervention in Xintai People's Hospital from June 2016 to September 2018 were selected. The clinical data of all patients were collected and followed up regularly for 12 months to record the occurrence of MACCE. SPSS 20 statistical software was used to process data. Results(1) Peripheral bloodmLR level was positively correlated with SYNTAX score of NSTEMI patients(r=0.575, P<0.05);(2) Multivariate COX regression analysis showed thatmLR, age, type 2 diabetes mellitus and hypertension were independent predictors of MACCE in NSTEMI patients;(3) ROC curve analysis showed that the area under the curve of predicting MACCE bymLR level in peripheral blood was 0.749(95% CI: 0.701～0.791), the best truncation value was 0.43, the sensitivity was 78.68%, and the specificity was 71.71%. Conclusion The level ofmLR in peripheral blood is positively correlated with the severity of coronary artery disease in NSTEMI patients, and it is an independent predictor of MACCE in NSTEMI patients. It can help to refine the risk stratification management of NSTEMI patients in clinical work.
引文
[1]徐帅,王莉.外周血中性粒细胞/淋巴细胞比值与急性ST段抬高型心肌梗死患者急性肾损伤的关系研究[J].实用心脑肺血管病杂志,2017,5(11):26-29.
[2]于永福,王岚峰.单核细胞/高密度脂蛋白比值与行急诊PCI的STEMI患者院内主要不良心血管事件的相关分析[J].中国循证心血管医学杂志,2017,9(8):963-965.
[3]刘爱军,钱雷,张永林,等.单核细胞LP-PLA2 mRNA表达在ST段抬高型心肌梗死再灌注愈后中的预测价值[J].海南医学,2018,9(7):12-16.
[4]中华医学会心血管病学分会.非ST段抬高急性冠状动脉综合征诊断和治疗指南[J].中华心血管病杂志,2012,40(5):353-367.
[5]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华高血压杂志,2011,39(8):701-708.
[6]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,30(8):447-498.
[7]周颖,汪小君,罗燕薇,等.循环单核细胞亚群联合肾功能对急性ST段抬高心肌梗死患者预后危险分层的评估[J].临床心血管病杂志,2017,33(6):534-539.
[8]任冬,张芯,刘新林,等.急性ST段抬高型心肌梗死入院即刻单核细胞与淋巴细胞比值与心血管事件相关性研究[J].中国实用内科杂志,2016,36(1):49-52.
[9]郑薇,周骐,靳鹏,等.NLR联合MLR在非ST段抬高型心肌梗死危险分层中的预测价值[J].检验医学与临床,2016,13(10):1297-1300.
[10]孙筱笛,齐国先,刘闺男.白细胞亚型对急性ST段抬高型及非ST段抬高型心肌梗死预后预测价值的研究进展[J].中国医刊,2017,52(4):24-27.
[11]郭英杰,宁彬,葛慧娟,等.血小板与淋巴细胞比值与NSTEMI患者冠状动脉病变严重程度的相关性研究[J].中国循证心血管医学杂志,2017,9(5):600-602.
[12]樊泽元,季汉华,李阳.非ST段抬高型急性冠脉综合征患者MLR变化及其与冠脉病变程度的关系[J].山东医药,2017,57(28):77-79.
[13]范婧尧,王晓,周生辉,等.中性粒细胞淋巴细胞比值与急性ST段抬高型心肌梗死患者冠状动脉病变严重程度的关联研究[J].中国心血管病研究,2018,16(2):15-19.
[14]王万虹,史波,丁浩,等.中性粒细胞/淋巴细胞比值与非ST段抬高型急性冠脉综合征的关系研究[J].实用心脑肺血管病杂志,2016,24(10):11-14.
[15]桂丹廷,黄炜璐,夏豪.ST段抬高型心肌梗死患者血小板计数/淋巴细胞与冠状动脉病变程度及短期预后的相关性[J].中国心血管病研究,2018,16(4):310-314.
[2]于永福,王岚峰.单核细胞/高密度脂蛋白比值与行急诊PCI的STEMI患者院内主要不良心血管事件的相关分析[J].中国循证心血管医学杂志,2017,9(8):963-965.
[3]刘爱军,钱雷,张永林,等.单核细胞LP-PLA2 mRNA表达在ST段抬高型心肌梗死再灌注愈后中的预测价值[J].海南医学,2018,9(7):12-16.
[4]中华医学会心血管病学分会.非ST段抬高急性冠状动脉综合征诊断和治疗指南[J].中华心血管病杂志,2012,40(5):353-367.
[5]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华高血压杂志,2011,39(8):701-708.
[6]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,30(8):447-498.
[7]周颖,汪小君,罗燕薇,等.循环单核细胞亚群联合肾功能对急性ST段抬高心肌梗死患者预后危险分层的评估[J].临床心血管病杂志,2017,33(6):534-539.
[8]任冬,张芯,刘新林,等.急性ST段抬高型心肌梗死入院即刻单核细胞与淋巴细胞比值与心血管事件相关性研究[J].中国实用内科杂志,2016,36(1):49-52.
[9]郑薇,周骐,靳鹏,等.NLR联合MLR在非ST段抬高型心肌梗死危险分层中的预测价值[J].检验医学与临床,2016,13(10):1297-1300.
[10]孙筱笛,齐国先,刘闺男.白细胞亚型对急性ST段抬高型及非ST段抬高型心肌梗死预后预测价值的研究进展[J].中国医刊,2017,52(4):24-27.
[11]郭英杰,宁彬,葛慧娟,等.血小板与淋巴细胞比值与NSTEMI患者冠状动脉病变严重程度的相关性研究[J].中国循证心血管医学杂志,2017,9(5):600-602.
[12]樊泽元,季汉华,李阳.非ST段抬高型急性冠脉综合征患者MLR变化及其与冠脉病变程度的关系[J].山东医药,2017,57(28):77-79.
[13]范婧尧,王晓,周生辉,等.中性粒细胞淋巴细胞比值与急性ST段抬高型心肌梗死患者冠状动脉病变严重程度的关联研究[J].中国心血管病研究,2018,16(2):15-19.
[14]王万虹,史波,丁浩,等.中性粒细胞/淋巴细胞比值与非ST段抬高型急性冠脉综合征的关系研究[J].实用心脑肺血管病杂志,2016,24(10):11-14.
[15]桂丹廷,黄炜璐,夏豪.ST段抬高型心肌梗死患者血小板计数/淋巴细胞与冠状动脉病变程度及短期预后的相关性[J].中国心血管病研究,2018,16(4):310-314.