NLR和PLR对胸痛的冠心病患者心肌肌钙蛋白I升高的预测价值
投稿时间:2014-10-31  修订日期:2014-11-18  点此下载全文
引用本文:屠春平,蔡云祥,邢铭芬,徐鸿斌.NLR和PLR对胸痛的冠心病患者心肌肌钙蛋白I升高的预测价值[J].医学研究杂志,2015,44(6):145-147
DOI: 10.11969/j.issn.1673-548X.2015.06.041
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作者单位
屠春平 313009 浙江省湖州市南浔人民医院检验科 
蔡云祥 313009 浙江省湖州市南浔人民医院检验科 
邢铭芬 313009 浙江省湖州市南浔人民医院检验科 
徐鸿斌 313000 浙江省湖州市第一人民医院检验科 
中文摘要:目的 探讨中性粒细胞-淋巴细胞比值(neutrophil-lymphocyte ratio, NLR)和血小板-淋巴细胞比值(platelet-lymphocyte ratio, PLR)对胸痛发作的冠心病患者心肌肌钙蛋白I(cardiac troponin I,cTnI)升高的预测价值。方法 测定198例cTnI水平正常的胸痛冠心病患者白细胞(white blood cell, WBC)参数、血小板计数(platelet, PLT)和C反应蛋白(C reactive protein, CRP)水平,计算NLR和PLR;留院观察6h后测定患者cTnI 浓度。分析cTnI升高患者各指标水平与cTnI 浓度的相关性,并以ROC曲线评价各指标的诊断效能。结果 cTnI 升高组就诊时WBC、NLR、PLR和CRP水平均显著高于cTnI正常组(P<0.05或0.001)。cTnI 升高组cTnI浓度 与WBC水平呈中度正相关(r=0.330,P=0.013),与NLR、PLR和CRP呈高度正相关(r=0.751、0.581和0.526,P=0.001),与PLT水平无相关性(r=0.130,P=0.155)。各指标的ROC曲线下面积分别为0.877(NLR)、0.804(PLR)、0.720(CRP)、0.616(WBC)。NLR预测cTnI升高的临界值为2.30,敏感度为80.4%,特异性为71.8%;PLR的临界值为83.4, 敏感度为75.0%,特异性为73.9%。结论 NLR和PLR对预测胸痛的冠心病患者cTnI升高有重要价值。
中文关键词:冠心病  胸痛  中性粒-淋巴细胞比值  血小板-淋巴细胞比值  心肌肌钙蛋白I  预测
 
Predictire Value of Neutrophil and Platelet-lymphocyte on Increasing Cardiac Troponin I in Chest Pain Patients with Coronary Artery Disease
Abstract:Objective To explore the predictire value of neutrophil-lymphocyte ratio(NLR) and platelet-lymphocyte ratio(PLR ) on increasing cardiac troponin I in chest pain attack patients with coronary artery disease. Methods White blood cell (WBC) and platelet parameters, C reactive protein(CRP) levels were measured in of patients chest pain and normal level of cardiac troponin I (cTnI) combined with coronary artery disease, and NLR and PLR were calculated. After 6 hours remaining in hospital, cTnI level of the patients was measured. The correlation between all indicators and cTnI level was analyzed in patients with increased cTnI level, and the ROC curve was used to evaluate the diagnostic efficacy. Results After 6 hours, WBC, NLR, PLR, CRP levels at group of increased cTnI were significantly higher than those at group of normal cTnI level (P<0.05). At group of elevated cTnI, cTnI showed moderate degree of positive correlation with WBC level (r=0.330,P=0.013), high degree of positive correlation with NLR, PLR and CRP levels (r=0.751, 0.581 and 0.526,P=0.001), but there was no correlation with PLT level(r=0.130, P=0.155). The area under ROC curve was 0.877 (NLR), 0804 (PLR), 0.720 (CRP), and 0.616 (WBC). The cut-off value of NLR to predict cTnI increasing was 2.30, sensitivity and specificity was 80.4% and 71.8%, respectively, which was 83.4, 75.0% and 73.9% for PLR, respectively. Conclusion There is important clinical significance for NLR and PLR to predict cTnI level increasing in patients of chest pain with coronary artery disease.
keywords:Coronary artery disease  Chest pain  Neutrophil-lymphocyte ratio  Platelet-lymphocyte ratio  Cardiac Troponin I  Prediction
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