单核细胞/高密度脂蛋白比值对冠心病患者不良心血管事件预测价值的分析

Predictive Value of Monocyte to High Density Lipoprotein Cholesterol Ratio for Adverse Cardiovascular Events in Patients with Coronary Heart Disease

摘要: 目的：探讨冠心病(CHD)患者单核细胞/高密度脂蛋白比值(MHR)预测近期心血管不良事件发生的价值。方法：选取2021年6月至2022年6月，在新疆自治区人民医院心内科确诊并收治的冠心病患者90例作为研究对象，记录随访CHD患者1年内出现的死亡、心肌梗死、再次血运重建等不良事件，根据其是否发生不良心血管事件(MACEs)分为MACEs组(14例)，未发生MACEs组(76例)。根据MHR水平将患者分为高MHR组和低MHR组，比较两组间发生MACEs的区别。绘制ROC工作曲线分析MHR预测冠心病不良事件的预测价值。结果：MACEs组性别、年龄、BMI、吸烟史、饮酒史、收缩压、血小板、D-二聚体、AST、ALT、血糖、肌酐等结果均无统计学差异(P > 0.05)。非MACEs组MHR、单核细胞水平低于MACEs组(P < 0.05)。单因素Logistic回归分析结果表明，MHR (OR = 20.695, 95% CI: 2.546~168.186, P = 0.005)，MHR与冠心病患者发生MACEs有相关性，多因素Logistic回归分析结果表明，MHR (OR = 122.128, 95% CI: 4.213~3839.963, P = 0.005)是冠心病患者MACE的危险因素。MHR预测发生MACEs的AUC、敏感度、特异性、最佳阶段点、最大约登指数分别为0.787 (95% CI: 0. 657~0.916)、71.4%、73.7%、0.60、0.45。高MHR组主要不良心血管事件发生率为33.33% (10/30)，高于低MHR组6.67% (4/60)，P < 0.05。结论：MHR是冠心病不良事件的危险因素，检测MHR水平对预测冠心病患者发生MACEs有一定价值。

Abstract: Objective: To investigate the value of monocyte to high density lipoprotein cholesterol ratio (MHR) in predicting in patients with coronary heart disease (CHD). Method: A total of 90 patients with coronary heart disease diagnosed and treated in the Department of Cardiology of Xinjiang Autono-mous Region People’s Hospital from June 2021 to June 2022 were selected as the study objects. Ad-verse events such as death, myocardial infarction and revascularization in CHD patients within 1 year of follow-up were recorded. They were divided into MACEs group (14 cases) and MACEs group (76 cases) according to whether they had adverse cardiovascular events (MACEs). Divide patients into high MHR group and low MHR group based on MHR levels, and compare the differences in the occurrence of MACEs between the two groups. Draw ROC working curves to analyze the predictive value of MHR in predicting adverse events of coronary heart disease. Results: There were no signif-icant differences in gender, age, BMI, smoking history, drinking history, systolic blood pressure, platelet, D-dimer, AST, ALT, blood glucose and creatinine in MACEs group (P > 0.05). The levels of MHR and monocyte in non-MACES group were lower than those in MACEs group (P < 0.05). The sin-gle factor logistic regression analysis results showed that MHR (OR = 20.695, 95% CI: 2.546~168.186, P = 0.005), there is a correlation between MHR and the occurrence of MACEs in pa-tients with coronary heart disease. The results of multivariate logistic regression analysis showed that MHR (OR = 122.228, 95% CI: 4.213~3839.963, P = 0.005) is a risk factor for MACE in patients with coronary heart disease. The AUC, sensitivity, specificity, optimal stage point and maximum Jordan index for predicting the occurrence of MACEs by MHR were 0.787 (95% CI: 0657~0 916), 71.4%, 73.7%, 0.60, 0.45. The incidence of major adverse cardiovascular events in the high MHR group was 33.33% (10/30), which was higher than 6.67% (4/60) in the low MHR group (P < 0.05). Conclusion: MHR is a risk factor for adverse CHD events, and detecting MHR levels has certain value in predicting the occurrence of MACEs in coronary heart disease patients in the short term.