| 超敏C反应蛋白与淋巴细胞比值和冠心病严重程度的相关性研究 |
| 投稿时间：2024-10-15 修订日期：2024-11-11 点此下载全文 |
| 引用本文：甘万深,费爱华.超敏C反应蛋白与淋巴细胞比值和冠心病严重程度的相关性研究[J].医学研究杂志,2025,54(3):147-151, 197 |
| DOI：
10.11969/j.issn.1673-548X.2025.03.027 |
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| 中文摘要:目的 探讨超敏C反应蛋白(high-sensitivity C-reactive protein, hs-CRP)与淋巴细胞比值(high-sensitivity C-reactive protein-to-lymphocyte ratio, CLR)和冠心病病情严重程度以及冠状动脉病变程度的相关性。方法 回顾性分析2022年1月～2023年11月在上海交通大学医学院附属新华医院住院行冠状动脉造影的患者603例。将所有患者根据临床分型分为非冠心病组、稳定型心绞痛(stable angina pectoris, SAP)组和急性冠状动脉综合征(acute coronary syndrome, ACS)组,根据冠状动脉Gensini评分将冠心病患者分为冠状动脉狭窄程度轻度(0～31分)、中度(31～61分)、重度(≥61分)3组,比较各组间CLR、中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio, NLR)的差异。采用受试者工作特征(receiver operating characteristic, ROC)曲线评估CLR、NLR、肌钙蛋白I对ACS的预测价值,采用Spearman相关性分析评估CLR、NLR与冠状动脉狭窄程度的相关性。结果 ACS组CLR高于SAP组,且SAP组高于非冠心病组,差异均有统计学意义(P＜0.05)；ACS组肌钙蛋白I、NLR高于SAP组,差异均有统计学意义(P＜0.05),但SAP组与非冠心病组之间差异无统计学意义(P＞0.05)；CLR、NLR、肌钙蛋白I预测ACS发生的曲线下面积(area under the curve, AUC)分别为0.787、0.730、0.837(P＜0.001)。在最佳截断值,CLR的敏感度为75.5%,特异性为71.6%；在轻、中、重度冠状动脉病变组中,随着冠状动脉狭窄程度的加重,NLR、CLR的水平也随之升高,差异均有统计学意义(P＜0.05)。Spearman相关性分析结果显示,CLR、NLR与冠心病患者的冠状动脉狭窄程度呈正相关(rCLR=0.308,rNLR=0.247,P＜0.001)。结论 CLR水平与冠心病患者病情严重程度以及冠状动脉病变程度呈正相关,相较于NLR以及肌钙蛋白I,CLR能更好地反映稳定期冠心病患者与非冠心病患者之间的差异,且对ACS患者的预测具有较高的敏感度,可为冠心病患者的早期诊断以及病情评估提供临床价值。 |
| 中文关键词:冠心病 超敏C反应蛋白 淋巴细胞 诊断 预测 |
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| Correlation between High-sensitivity C-reactive Protein-to-Lymphocyte Ratio and Severity of Coronary Heart Disease. |
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| Abstract:Objective To explore the correlation between high-sensitivity C-reactive protein (hs-CRP)-to-lymphocyte ratio (CLR) and the severity of coronary heart disease, as well as the degree of coronary artery lesions. Methods A total of 603 patients who underwent coronary angiography in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2022 to November 2023 were conducted on the retrospective analysis. All patients were divided into non-coronary heart disease group, stable angina pectoris (SAP) group, and acute coronary syndrome (ACS) group according to clinical classification. Basing on the Gensini score for coronary arteries, the extent of stenosis in patients′ coronary arteries was classified into mild (0-31 points), moderate (31-61points), and severe (≥61 points) groups. Differences in CLR and neutrophil-to-lymphocyte ratio (NLR) among groups were compared. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of CLR, NLR, and troponin I for ACS. Spearman correlation analysis was used to evaluate the correlation between CLR, NLR and the degree of coronary stenosis. Results The CLR in the ACS group was higher than that in the SAP group, which was in turn higher than that in the non-coronary heart disease group, the differences were statistically significant (P＜0.05). The troponin I and NLR in the ACS group were significantly higher than those in the SAP group (P＜0.05), but there was no statistical significance between the SAP group and non-coronary heart disease group (P＞0.05); the area under the curve (AUC) of CLR, NLR and troponin I in predicting ACS were 0.787,0.730 and 0.837, respectively (P＜0.001). At the optimal cut-off value, the sensitivity and specificity of CLR were 75.5 % and 71.6 %. In the mild, moderate, and severe coronary lesion groups, with the degree of coronary stenosis worsened, levels of NLR and CLR increased correspondingly, and the differences were statistically significant (P＜0.05); Spearman correlation analysis demonstrated a positive correlation between CLR, NLR and the degree of coronary stenosis in coronary heart disease patients (rCLR=0.308, rNLR=0.247, P<0.001). Conclusion Levels of CLR have a positive correlation with the severity of disease and the degree of coronary artery lesions in coronary heart disease patients. Compared with NLR and troponin I, it can better reflect the differences between stable-phase coronary heart disease patients and non-coronary heart disease patients, and has a higher sensitivity in predicting ACS patients, providing clinical value for early diagnosis and condition evaluation in coronary heart disease patients. |
| keywords:Coronary heart disease High-sensitivity C-reactive protein Lymphocytes Diagnosis Prediction |
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