NLR与老年急性冠脉综合征患者的冠脉狭窄程度的相关性

The Correlation between NLR and the Degree of Coronary Artery Stenosis in Elderly Patients with Acute Coronary Syndrome

摘要: 目的：探究中性粒细胞与淋巴细胞比值与老年急性冠脉综合征患者的冠脉狭窄程度的相关性及对严重冠脉狭窄的诊断效能。方法：回顾性收集2022年8月至2024年8月于邯郸市中心医院行冠状动脉造影术的老年急性冠脉综合征患者共154例，其UA组79例(男性41例，女性38例)，AMI组75例(男性57例，女性18例)，选取Gensini评分对冠脉造影结果进行评估，分为中低分组(GS < 68)，高分组(GS ≥ 68)。结果：(1) UA组和AMI组在高脂血症、收缩压、WBC、NEUT、HDL-C、TC、NLR评分的比较，差异存在统计学意义(P < 0.05)；(2) WBC、NEUT、LDL-C、TG、NLR均与Gensini评分呈正相关(P < 0.05)，LYM、HDL-C与Gensini评分呈负相关(P < 0.05)；(3) 不同Gensini评分分组在WBC、NEUT、LYM、LDL-C、HDL-C、TG、NLR的差异具有统计学意义(P < 0.05)；(4) 多因素logistic回归分析结果进一步显示NLR、LDL-C、TG是Gensini评分的独立危险因素。(5) ROC曲线显示NLR诊断老年急性冠脉综合征患者的严重冠脉狭窄的截断值为2.978，灵敏度90.0%，特异度54.4%，曲线下面积0.773 (95% CI: 0.699~0.846)。结论：NLR与老年急性冠脉综合征患者的冠脉狭窄程度呈正相关，是冠脉严重狭窄的独立危险因素。

Abstract: Objective: To explore the correlation between the neutrophil-to-lymphocyte ratio and the degree of coronary artery stenosis in elderly patients with acute coronary syndrome, as well as the diagnostic efficacy for severe coronary artery stenosis. Methods: A total of 154 elderly patients with acute coronary syndrome who underwent coronary angiography at Handan Central Hospital from August 2022 to August 2024 were retrospectively collected. There were 79 patients in the UA group (41 males and 38 females) and 75 patients in the AMI group (57 males and 18 females). The Gensini score was used to evaluate the coronary angiography results, and the patients were divided into the low-middle score group (GS < 68) and the high score group (GS ≥ 68). Results: (1) There were statistically significant differences in high lipidemia, systolic blood pressure, WBC, NEUT, HDL-C, TC, and NLR scores between the UA group and the AMI group (P < 0.05); (2) WBC, NEUT, LDL-C, TG, NLR were positively correlated with the Gensini score (P < 0.05), while LYM and HDL-C were negatively correlated with the Gensini score (P < 0.05); (3) There were statistically significant differences in WBC, NEUT, LYM, LDL-C, HDL-C, TG, and NLR among different Gensini score groups (P < 0.05); (4) The results of multivariate logistic regression analysis further showed that NLR, LDL-C, and TG were independent risk factors for the Gensini score. (5) The ROC curve showed that the cutoff value of NLR for diagnosing severe coronary artery stenosis in elderly patients with acute coronary syndrome was 2.978, with a sensitivity of 90.0%, a specificity of 54.4%, and an area under the curve of 0.773 (95% CI: 0.699~0.846). Conclusion: NLR is positively correlated with the degree of coronary artery stenosis in elderly patients with acute coronary syndrome and is an independent risk factor for severe coronary artery stenosis.