中性粒细胞与淋巴细胞比值与非ST段抬高急性冠状动脉综合征及其严重程度关系研究

目的 研究中性粒细胞与淋巴细胞比值（NLR）与非ST段抬高急性冠状动脉综合征（NSTE-ACS）的关系,探讨NLR对NSTE-ACS患者冠状动脉病变严重程度的预测作用.方法 将307例患者依据冠状动脉造影结果 分为NSTE-ACS组226例和非冠心病组81例,NSTE-ACS组又以SYNTAX评分结果 分为低危组（1～22分）137例、中危组（23～32分）47例及高危组（≥33分）42例.检测外周血白细胞分类计数并计算NLR,应用SAS 9.2软件进行统计分析.结果 （1）NSTE-ACS的中、高危亚组NLR与非冠心病组间差异均有统计学意义（P〈0.05）;NSTE-ACS各亚组中,高危组NLR与中危组和低危组间差异均有统计学意义（P〈0.05）,中危组NLR与低危组间差异亦有统计学意义（P〈0.05）,单因素及多因素Logistic回归分析显示NLR与年龄、高血压及糖尿病均是NSTE-ACS的独立危险因素.（2）线性分析显示NLR与NSTE-ACS患者冠状动脉病变严重程度呈正相关（r=0.538,P〈0.05）.（3）受试者工作特征曲线（ROC曲线）显示NLR的曲线下面积为0.664（95% CI：0.599～0.730）,且当NLR切值取2.145时,其诊断效率最高,敏感性为58%,特异性为71.6%.结论 NLR是NSTE-ACS的独立危险因素,且NLR与NSTE-ACS患者冠状动脉病变严重程度呈正相关.

Association of the neutrophil to lymphocyte ratio and the non-ST-elevation acute coronary syndrome and itsseverity

Objective To investigate the relationship between the neutrophil to lymphocyte ratio（NLR） and the non-ST-elevation acute coronary syndrome （NSTE-ACS） and its severity. Methods A total of 307 hospitalized patients undergoing coronary angiography were included in the study. Control group consisted of patients with normal coronary arteries. Patients with coronary stenosis who has been confirmed as NSTE-ACS by at least one cardiologist were divided into 3 groups according to SYNTAX scores. White blood eel count, neutrophil count and lymphocyte count were measured, NLR was calculated. Statistical analyses were performed using SAS 9.2. Results （ 1 ） The NLR was higher in high risk group and mild risk group compared with control group （P 〈 0. 05 ）, the NLR was higher in high risk group compared with mild risk group and low risk group （ P 〈 0.05 ）, the NLR was higher in mild risk group compared with low risk group （ P 〈 O. 05 ）. After univariate and multivariate logistic regression analysis, NLR was an independent risk predictor of NSTE-ACS together with age, arterial hypertension and diabetes mellitus. （2） In correlation analysis, NLR showed significant correlation with SYNTAX scores （ r = 0. 538, P 〈 0. 05 ） which can reflect the severity of coronary lesions. （ 3 ） In a receiver-operating characteristic curve analysis, an NLR value of 2. 145 was identified as an effective cut point in predicting NSTE-ACS with a sensitivity and specificity of 58% and 71.6% （ AUC =0. 664,95% CI：0. 599-0. 730）. Conclusions NLR is not only an independent risk predictor of NSTE-ACS but also can reflect the severity of coronary lesions.