冠脉微循环指数、炎症状态与老年冠心病患者病情程度相关性分析

Correlation analysis of coronary microcirculation index and inflammatory status and severity of coronary heart lesions in eld-erly patients

中文关键词: 老年  冠心病  炎症  冠脉微循环指数  中性粒细胞与淋巴细胞比值  血小板与淋巴细胞比值  相关性

英文关键词: elderly  coronary heart disease  inflammation  coronary microcirculation index  neutrophil to lymphocyte ratio  platelet to lymphocyte ratio  correlation

中文摘要:

      目的 分析冠脉微循环指数、炎症状态与老年冠心病患者冠脉病变程度的相关性.方法 回顾性选择2021年1月-2024年1月西部战区总医院收治的老年冠心病患者进行研究,共纳入79例患者,通过检测患者外周血炎症指标值[中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)]及冠脉微循环指标值[微循环阻力指数(AMR)],分析其与冠脉病变程度的相关性.结果 79例老年患者中轻度病变48例,中重度病变31例;中重度病变组NLR、PLR、AMR值明显高于轻度病变组(P＜0.05).单因素分析显示,高龄、合并高血压、高脂血症、糖尿病与冠脉中重度病变有关(P＜0.05).Spearman相关性显示,NLR、PLR、AMR值与冠脉病变程度呈正相关(r=0.300、0.400、0.484,P＜0.05);Pearson相关性显示,NLR、PLR值与AMR值呈正相关(P＜0.05).Logistic回归分析显示,高龄、合并高血压、高脂血症、糖尿病及NLR、PLR、AMR水平对冠脉中重度病变具有正向作用(P＜0.05).ROC曲线显示,NLR、PLR、AMR评估冠脉中重度病变的AUC分别为0.677、0.736、0.786,最大约登指数下的灵敏度、特异度、最佳截断值分别为0.678、0.729、2.620;0.581、0.875、121.760;0.484、1.000、0.786.结论 冠脉微循环指数、炎症状态异常可能与老年冠心病患者冠脉病变程度相关,且对患者病情发展至中重度具有一定的评估价值.

英文摘要:

      Objective To analyze the correlation of coronary microcirculation index and inflammatory status and severi-ty of coronary artery lesions in elderly patients with coronary heart disease(CHD).Methods Elderly patients with CHD ad-mitted to General Hospital of Western Theater Command from January 2021 to January 2024 were retrospectively selected for the study,and a total of 79 ones were included.The peripheral blood inflammation indicators[neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)]and coronary microcirculation indicator[angio-based index of microcirculato-ry resistance(AMR)]were detected.The correlation between these indicators and the severity of coronary artery lesions was analyzed.Results Among the 79 elderly patients,48 cases had mild lesions and 31 ones had moderate-to-severe lesions.The levels of NLR,PLR and AMR in the moderate-to-severe lesion group were significantly higher than those in the mild lesion group(P＜0.05).Univariate analysis showed that advanced age,hypertension,hyperlipidemia and diabetes mellitus were as-sociated with moderate-to-severe coronary artery lesions(P＜0.05).Spearman correlation analysis suggested that the levels of NLR,PLR and AMR were positively correlated with the severity of coronary artery lesions(r=0.300,0.400,0.484,P＜0.05).Pearson correlation analysis showed that the levels of NLR and PLR were positively correlated with the level of AMR(P＜0.05).Logistic regression analysis found that advanced age,hypertension,hyperlipidemia,diabetes mellitus and the lev-els of NLR,PLR and AMR had positive effects on moderate-to-severe coronary artery lesions(P＜0.05).ROC curve showed that the AUCs of NLR,PLR and AMR were 0.677,0.736 and 0.786 in evaluating moderate-to-severe coronary artery lesions,respectively,and the sensitivity,specificity and optimal cut-off value under the maximum Youden index were 0.678,0.729 and 2.620,0.581,0.875 and 121.760,and 0.484,1.000 and 0.786,respectively.Conclusion The abnormal coronary mi-crocirculation index and inflammatory status are related to severity of coronary artery lesions in elderly patients with CHD,and have a certain value in evaluating the progression of patients'disease to moderate and severe.