NLR与冠状动脉慢血流的相关性研究

Correlation Study of NLR and Coronary Slow Flow

摘要: 目的：本研究目的在于讨论中性粒细胞与淋巴细胞比值(NLR)在冠状动脉慢血流(CSF)中可能存在的病理生理机制及它对慢血流的预测价值。方法：本研究选取了于2018~2020年期间因“胸痛、胸闷”等原因入住青岛大学附属医院心血管内科并接受冠脉造影(Coronary angiogram, CAG)检查的患者，最终纳入362例(n = 362例)进行研究。其中慢血流患者203例(n = 203)。对照组为同期行冠脉造影检查结果表示正常冠状动脉血流的患者(Normal coronary flow, NCF)，共159例(n = 159)。收集慢血流组和对照组组患者的一般临床资料及血常规、生化指标进行数据统计分析。应用多因素Logistic回归分析确定CSF的独立危险因素，通过绘制受试者工作曲线(Receiver operating characteristic curve, ROC)来进一步进行判断本文研究指标对慢血流的预测价值。P < 0.05则认为本次的数据结果具有统计学意义。结果：1) 基础资料对比结果显示慢血流组的男性比例、年龄、NLR水平显著高于对照组(P < 0.05)。2) 通过多因素Logistic回归分析可以看出男性比例、NLR水平是慢血流的独立危险因素。3) ROC曲线分析结果示NLR曲线下面积为0.714，最佳截断值为2.92，此时NLR预测慢血流的灵敏度为49.75%，特异度为90.57%。结论：男性、NLR是慢血流的独立危险因素。且NLR可以用来预测慢血流的发生。

Abstract: Objective: The purpose of this study is to discuss the possible pathophysiological mechanisms of neutrophil-to-lymphocyte ratio (NLR) in coronary slow flow (CSF) and its predictive value for coronary slow flow. Methods: In this study, 362 patients (n = 362) who were admitted to the Department of Cardiovascular Medicine of the Affiliated Hospital of Qingdao University for “chest pain and chest tightness” and underwent coronary angiogram (CAG) during the period of 2018~ 2020 were selected for the study. Among them, 203 patients (n = 203) had coronary slow flow. The control group was 159 patients (n = 159) who had normal coronary flow (NCF) as indicated by the results of coronary angiography during the same period. The general clinical data and routine blood and biochemical indexes of patients in the coronary slow flow and control groups were collected for statistical analysis of the data. The independent risk factors of CSF were determined by multi-factor Logistic regression analysis, and the predictive value of the study indexes on slow flow was further determined by plotting the receiver operating characteristic curve (ROC). P < 0.05 is considered statistically significant. Results: 1) The results of the comparison of basic data showed that the male proportion, age, and NLR level were significantly higher in the CSF group than in the control group (P < 0.05). 2) The multi-factor Logistic regression analysis showed that the male proportion and NLR level were independent risk factors for CSF. 3) ROC curve analysis results showed that the area under the NLR curve was 0.714 and the optimal cut-off value was 2.92, at which time the sensitivity of NLR in predicting CSF was 49.75% and the specificity was 90.57%. Conclusions: Male and NLR are independent risk factors for CSF. NLR can be used to predict the occurrence of CSF.