摘要
目的探讨稳定型冠心病(SCHD)合并中年肥胖患者血清中性粒细胞与淋巴细胞比值(NLR)、高敏心肌肌钙蛋白T(hs-cTnT)、小而密低密度脂蛋白胆固醇(sdLDL-C)表达水平及与病情严重程度的相关性。方法选取2022年5月—2023年7月在沧州市人民医院接受治疗的SCHD患者(n=245)为SCHD组,另选择同期健康体检者(n=245)作为对照组。测定血清NLR、hs-cTnT、sdLDL-C表达水平;分析SCHD合并肥胖患者血清NLR、hs-cTnT、sdLDL-C与Gensini评分的相关性及影响病情严重程度的因素;血清NLR、hs-cTnT、sdLDL-C水平对SCHD合并肥胖患者病情严重程度的诊断效能,绘制受试者操作特征(ROC)曲线分析。结果SCHD组的体质量指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均高于对照组,高密度脂蛋白胆固醇(HDL-C)水平低于对照组(t=11.041、13.686、12.898、6.196、9.968,均P<0.05)。与对照组相比,SCHD组患者的NLR、hs-cTnT、sdLDL-C表达水平均显著升高(t=42.342、28.256、22.880,均P<0.05)。与SCHD正常组相比,SCHD超重组、SCHD肥胖组患者的NLR、hs-cTnT、sdLDL-C表达水平均显著升高(F=75.624、31.360、12.729,均P<0.05)。与低危组相比,高危组SCHD合并肥胖患者血清NLR、hs-cTnT、sdLDL-C表达水平、Gensini评分均显著升高(t=7.487、4.091、3.740、15.574,均P<0.05)。SCHD合并肥胖患者NLR、hs-cTnT、sdLDL-C表达水平与Gensini评分存在正相关性(r=0.596、0.509、0.481,均P<0.05)。多因素Logistic回归分析发现,血清NLR、hs-cTnT、sdLDL-C表达水平均是影响SCHD合并肥胖患者病情严重程度的危险因素(均P<0.05)。血清NLR、hs-cTnT、sdLDL-C三者联合诊断SCHD合并肥胖患者病情严重程度的曲线下面积(AUC)最高,优于血清NLR、hs-cTnT、sdLDL-C三者各自单独诊断(Z=2.117、3.203、3.718、均P<0.05)。结论SCHD合并中年肥胖患者血清NLR、hs-cTnT、sdLDL-C表达水平显著升高,三者联合可以更好地诊断病情严重程度。
Objective To explore the expression levels of serum neutrophil/lymphocyte ratio(NLR),highly sensitive cardiac troponin T(hs-cTnT),small and dense low-density lipoprotein cholesterol(sdLDL-C),and their correlation with the severity of stable coronary heart disease(SCHD)combined with middle-aged obesity in patients.Methods SCHD patients(n=245)who received treatment in Cangzhou People’s Hospital from May 2022 to July 2023 were regarded as the SCHD group,and healthy individuals(n=245)who underwent physical examinations were as the reference group.The expression levels of serum NLR,hs-cTnT,and sdLDL-C were measured;To analyze the correlation between serum NLR,hs-cTnT,sdLDL-C and Gensini score in patients with SCHD with obesity and the factors affecting the severity of the disease.Diagnostic efficacy of serum NLR,hs-cTnT,and sdLDL-C levels on the severity of the disease in patients with SCHD complicated with obesity;analysis of receiver operating characteristic(ROC)curve of subjects.Results The body mass index(BMI),total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)levels of SCHD group were higher than those of the control group,while the high density lipoprotein cholesterol(HDL-C)level was lower than that of the control group(t=11.041,13.686,12.898,6.196,9.968,all P<0.05).Compared with the control group,the expression levels of NLR,hs-cTnT and sdLDL-C in patients of SCHD group were significantly increased(t=42.342,28.256,22.880,all P<0.05).Compared with the normal SCHD group,the expression levels of NLR,hs-cTnT and sdLDL-C in patients with SCHD hyperreconstruction and SCHD obesity were significantly increased(F=75.624,31.360,12.729,all P<0.05).Compared with the low-risk group,the serum NLR,hs-cTnT,sdLDL-C expression levels and Gensini score of patients with SCHD combined with obesity in the high-risk group were significantly increased(t=7.487,4.091,3.740,15.574,all P<0.05).The expression levels of NLR,hs-cTnT and sdLDL-C in patients with obesity combined with SCHD were positively correlated with Gensini score(r=0.596,0.509,0.481,all P<0.05).Multiple factor Logistic regression analysis found that serum NLR,hs-cTnT and sdLDL-C expression levels were all risk factors affecting the severity of SCHD combined with obesity(all P<0.05).The area under the curve(AUC)of serum NLR,hs-cTnT and sdLDL-C combined diagnosis of the severity of SCHD combined with obesity was the highest,which was better than the diagnosis of serum NLR,hs-cTnT and sdLDL-C alone(Z=2.117,3.203,3.718,all P<0.05).Conclusion The expression levels of serum NLR,hs-cTnT,and sdLDL-C in patients with SCHD combined with middle-aged obesity are obviously increased,and the combination of them can better diagnose the severity of the disease.
作者
张妍
孙美玲
吕晓婷
张渤
刘晓明
ZHANG Yan;SUN Meiling;LYU Xiaoting;ZHANG Bo;LIU Xiaoming(Department of Laboratory,Cangzhou People’s Hospital,Cangzhou Hebei 061000,China)
出处
《中国急救复苏与灾害医学杂志》
2025年第6期785-789,795,共6页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
河北省2023年度医学科学研究课题计划项目(202320)。
