不同性别不稳定型心绞痛患者血清中MHR和NLR与SYNTAX评分的相关性

Correlation of Serum MHR and NLR with SYNTAX Scores in Patients with Unstable An-gina Pectoris of Different Genders

摘要: 目的：探究不同性别不稳定性心绞痛患者中单核细胞/高密度脂蛋白胆固醇比值(MHR)和中性粒细胞与淋巴细胞比值(NLR)与SYNTAX评分的相关性。方法：本研究纳入依据冠状动脉造影(CAG)检查并确诊为不稳定性心绞痛的患者400例。按照SYNTAX评分分为高危组和低危组，并比较两组的年龄、高血压史、BMI、性别、糖尿病史、高血脂、冠心病/心衰、脑梗、吸烟、甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白、肌酐、尿酸、胱抑素C、白细胞、NLR、左室射血分数(LVEF)和MHR等。按照性别分组，分别分析患者血清MHR和NLR与男女患者SYNTAX评分的相关性。基于多因素logistic回归方法分析影响男性不稳定型心绞痛患者SYNTAX评分的危险因素。受试者工作(ROC)曲线测试单独NLR与MHR及其联合预测不稳定性心绞痛患者SYNTAX评分高低。结果：SYNTAX评分高危组和低危组相比，男性比例、吸烟史、尿酸、NLR、MHR、LVEF差异具有统计学意义。进一步把男性和女性患者分开分析发现，男性不稳定型心绞痛患者中糖尿病史、高血脂、脑梗、吸烟、甘油三酯、尿酸、胱抑素、NLR、LVEF和MHR在SYNTAX评分低危和高危组存在统计学差异。女性患者中不同SYNTAX评分分级的显著差异指标有吸烟、肌酐和LVEF (P < 0.05)。多因素logistic回归结果表明吸烟、NLR、LVEF、MHR是影响男性不稳定心绞痛患者SYNTAX评分的危险因素。NLR和MHR预测SYNTAX评分风险的ROC曲线下面积为0.645、0.728、0.759，联合NLR与MHR预测效果优于单一指标。结论：MHR和NLR与男性不稳定型心绞痛患者SYNTAX评分相关，联合NLR与MHR预测SYNTAX评分风险有一定价值。

Abstract: Objective: To investigate the correlation between MHR and NLR and SYNTAX score in patients with unstable angina pectoris (UA) of different genders. Methods: A total of 400 unstable angina pectoris patients were diagnosed by coronary angiography (CAG). The high-risk group and low-risk group were divided according to the SYNTAX score. Age, history of hypertension, BMI, gender, diabetes, hyperlipidemia, triglyceride, heart disease/heart failure, total cholesterol, cerebral infarction, smoking, high-and low-density lipoprotein, creatinine, uric acid, cystatin C, white blood cell, NLR, and high blood pressure were respectively collected and compared between high- and low- groups. The correlation between serum MHR and NLR and SYNTAX score of male and female patients was analyzed according to gender grouping. Multivariate logistic analysis was performed to detect the risk factors of SYNTAX score in male patients with unstable angina pectoris. Receiver operating (ROC) curve was used to analyze the SYNTAX score of patients with unstable angina pectoris pre-dicted by NLR and MHR alone or in combination. Results: Male proportion, smoking history, uric acid, NLR, MHR, and LVEF were statistically significant between high- and the low-SYNTAX score group. In the further analysis, the history of diabetes, hyperlipidemia, cerebral infarction, smoking, triglyceride, uric acid, cystatin, NLR, LVEF and MHR were different in the low- and high-SYNTAX score groups in male UA patients. However, smoking, creatine, and LVEF (P < 0.05) were different in the low- and high-SYNTAX score groups in female UA patients. Multivariate logistic analysis re-vealed that LVEF, smoking, NLR, and MHR were risk factors affecting SYNTAX score of male UA pa-tients. The area under ROC curve of NLR and MHR to predict SYNTAX score risk was 0.645, 0.728, 0.759, and the prediction effect of combined NLR and MHR was better than that of a single index. Conclusions: MHR and NLR are correlated with SYNTAX score in male patients with unstable angina pectoris, and the combination of NLR and MHR has certain value in predicting SYNTAX score risk.