中性粒细胞–淋巴细胞比率与冠状动脉病变严重程度的关系

Relationship between Neutrophil-Lymphocyte Ratio and the Severity of Coronary Artery Disease

摘要: 目的：研究冠心病患者中性粒细胞与淋巴细胞比率(Neutrophil/lymphocyte ratio, NLR)水平与冠心病(coronary heart disease, CHD)严重程度的关系。方法：选择在我院接受冠状动脉造影(CAG)的356例病人为研究对象，根据CAG结果分为CHD组(260例)和非CHD组(96例)，比较两组病人的NLR水平。根据冠状动脉病变支数和冠状动脉狭窄程度积分(SYNTAX评分)将冠心病组分为不同亚组，进一步比较各亚组NLR的差异，并分析NLR冠状动脉病变严重程度的关系。结果：CHD中高危组间NLR水平明显高于CHD低危组，差异有统计学意义(P < 0.05)。将SYNTAX评分及NLR进行Pearson相关分析显示，SYNTAX评分与NLR水平呈正相关(r = 0.973, P < 0.05)，二元Logitic回归分析结果显示：NLR为冠心病的独立预测因子，NLR的ROC (接受者操作特征)曲线下面积0.979 (0.966~0.993, P < 0.05)，NLR预测冠心病严重程度的最佳诊断分界点为3.38，敏感度为95.9%，特异度为91.3%。结论：NLR水平可作为评估冠状动脉病变程度的指标。

Abstract: Objective: To study the relationship between Neutrophil/lymphocyte ratio (NLR) and the severity of coronary heart disease (CHD). Methods: 356 patients who underwent coronary angiography (CAG) in our hospital were selected as the research subjects. According to the results of CAG, they were divided into CHD group (260 cases) and non-CHD group (96 cases), and the NLR levels of the two groups were compared. The CHD group was divided into different subgroups according to the number of coronary artery lesions and the degree of coronary artery stenosis score (SYNTAX score), and the differences in NLR in each subgroup were further compared, and the relationship between the severity of coronary artery lesions in NLR was analyzed. Results: The level of NLR in CHD high-risk group was significantly higher than that in CHD low-risk group, and the difference was statistically significant (P < 0.05). The SYNTAX score and NLR Pearson correlation analysis showed that SYNTAX score was positively correlated with NLR level (r = 0.973, P < 0.05), dual Logistic regression analysis results showed that NLR is an independent predictor of coronary heart disease (CHD). The area under the ROC curve of NLR was 0.979 (0.966~0.993, P < 0.05). The optimal diagnostic cutoff point of NLR for predicting the severity of CHD was 3.38, with sensitivity of 95.9% and specificity of 91.3%. Conclusion: NLR level can be used as an indicator to evaluate the degree of coronary artery disease.