中性粒细胞与淋巴细胞和血小板比值与冠状动脉病变严重程度的相关性

摘要/Abstract

摘要： 目的探讨中性粒细胞与淋巴细胞和血小板比值（NLPR）在冠脉病变严重程度中的预测价值。方法 385例患者接受了冠脉造影,其中无冠心病组106例,冠心病组279例,再根据Gensini积分将冠心病组分为轻度狭窄组（1-29分）128例和重度狭窄组（≥30分）151例。检测各组患者行冠脉前外周静脉血中性粒细胞数、淋巴细胞数、血小板数等基础生化指标,并计算NLPR并统计各组间差异。结果（1）冠心病组NLPR高于无冠心病组,冠脉重度狭窄组NLPR高于冠脉轻度狭窄组,差异具有统计学意义（P<0.05）。（2）Spearman相关性分析显示NLPR与冠脉狭窄严重程度呈正相关（r=0.262,P<0.001）。（3）多因素Logistic回归分析显示,NLPR是冠脉重度狭窄的独立风险因素（OR=1.533,95%CI为1.189-1.975,P=0.001）。（4）ROC曲线显示NLPR对重度冠脉狭窄有较好的预测价值。结论 NLPR是冠心病患者冠脉重度狭窄的独立风险因素,且对冠脉重度狭窄有着良好的预测价值。

关键词: 冠状动脉疾病, 中性粒细胞, 淋巴细胞, 血小板, 严重程度, 比值

曹少清, 李成思, 王张羽, 王玉琴, 叶江平, 刘叶红, 靳天慧, 宗刚军. 中性粒细胞与淋巴细胞和血小板比值与冠状动脉病变严重程度的相关性[J]. 心血管病防治知识, 2023, 13(27): 22-26.

参考文献

[1] Ralapanawa U, Sivakanesan R.Epidemiology and the Magnitude of Coronary Artery Disease and Acute Coronary Syndrome: A Narrative Review[J]. J Epidemiol Glob Health, 2021, 11(2): 169-177.
[2] Libby P, Theroux P.Pathophysiology of coronary artery disease[J]. Circulation, 2005, 111(25): 3481-3488.
[3] Fioranelli M, Bottaccioli AG, Bottaccioli F, et al.Stress and Inflammation in Coronary Artery Disease: A Review Psychoneuroendocrineimmunology-Based[J]. Front Immunol, 2018, 9: 2031.
[4] Lawler PR, Akinkuolie AO, Chu AY, et al.Atherogenic Lipoprotein Determinants of Cardiovascular Disease and Residual Risk Among Individuals With Low Low-Density Lipoprotein Cholesterol[J]. J Am Heart Assoc, 2017, 6(7).
[5] Khera AV, Kathiresan S.Genetics of coronary artery disease: discovery, biology and clinical translation[J]. Nat Rev Genet, 2017, 18(6): 331-344.
[6] Chen J, Chen MH, Li S,et al.Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting the Severity of Coronary Artery Disease: A Gensini Score Assessment[J]. Journal of Atherosclerosis and Thrombosis, 2014, 21(12): 1271-1282.
[7] Gaggini M, Minichilli F, Gorini F, et al.FIB-4 Index and Neutrophil-to-Lymphocyte-Ratio as Death Predictor in Coronary Artery Disease Patients[J]. Biomedicines, 2022, 11(1).
[8] Liu Y, Ye T, Chen L, et al.Systemic immune-inflammation index predicts the severity of coronary stenosis in patients with coronary heart disease[J]. Coron Artery Dis, 2021, 32(8): 715-720.
[9] Yang YL, Wu CH, Hsu PF, et al.Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease[J]. Eur J Clin Invest, 2020, 50(5): e13230.
[10] Gameiro J, Fonseca JA, Dias JM, et al.Neutrophil, lymphocyte and platelet ratio as a predictor of postoperative acute kidney injury in major abdominal surgery[J]. BMC Nephrol, 2018, 19(1): 320.
[11] Fois AG, Paliogiannis P, Scano V, et al.The Systemic Inflammation Index on Admission Predicts In-Hospital Mortality in COVID-19 Patients[J]. Molecules, 2020, 25(23).
[12] Ryan TJ, Bauman WB, Kennedy JW, et al.Guidelines for percutaneous transluminal coronary angioplasty. A report of the American Heart Association/American College of Cardiology Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Committee on Percutaneous Transluminal Coronary Angioplasty)[J]. Circulation, 1993, 88(6): 2987-3007.
[13] Gensini GG.A more meaningful scoring system for determining the severity of coronary heart disease[J]. Am J Cardiol, 1983, 51(3): 606.
[14] Khandelwal V, Kapoor A, Kazmi D, et al.Exploring the association of fibrinogen and CRP with the clinical spectrum of CAD and periprocedural outcomes in patients undergoing percutaneous coronary interventions[J]. Ann Card Anaesth, 2022, 25(1): 34-40.
[15] Petzold T, Zhang Z, Ballesteros I, et al.Neutrophil "plucking" on megakaryocytes drives platelet production and boosts cardiovascular disease[J]. Immunity, 2022, 55(12): 2285-99 e7.
[16] Ommen SR, Gibbons RJ, Hodge DO, et al.Usefulness of the lymphocyte concentration as a prognostic marker in coronary artery disease[J]. Am J Cardiol, 1997, 79(6): 812-814.
[17] Gawaz M, Langer H, May AE.Platelets in inflammation and atherogenesis[J]. J Clin Invest, 2005, 115(12): 3378-3384.
[18] Ibrahim H, Kleiman NS.Platelet pathophysiology, pharmacology, and function in coronary artery disease[J]. Coron Artery Dis, 2017, 28(7): 614-623.
[19] Angkananard T, Anothaisintawee T, McEvoy M, et al. Neutrophil Lymphocyte Ratio and Cardiovascular Disease Risk: A Systematic Review and Meta-Analysis[J]. Biomed Res Int, 2018, 2018: 2703518.
[20] Gameiro J, Fonseca JA, Jorge S, et al.Neutrophil, lymphocyte and platelet ratio as a predictor of mortality in septic-acute kidney injury patients[J]. Nefrologia (Engl Ed), 2020, 40(4): 461-468.
[21] Li Y, Zou Z, Zhang Y, et al.Dynamics in perioperative neutrophil-to-lymphocyte*platelet ratio as a predictor of early acute kidney injury following cardiovascular surgery[J]. Ren Fail, 2021, 43(1): 1012-1019.
[22] Koo CH, Eun Jung D, Park YS, et al.Neutrophil, Lymphocyte, and Platelet Counts and Acute Kidney Injury After Cardiovascular Surgery[J]. J Cardiothorac Vasc Anesth, 2018, 32(1): 212-222.