| Objective To analyze the correlation between monocyte count/HDL-C ratio(MHR)and cumulative LDL-C exposure load(CLEL)and SYNTAX score in CHD patients,and discuss the correlation between MHR and CLEL and the severity of coronary atherosclerosis lesion in CHD patients as well as its clinical significance.Methods A total of 735 patients with coronary heart disease who were admitted to the department of cardiology of Affiliated Hospital of Zunyi Medical University for CAG examination from January 2018 to August 2018 were selected.According to the results of CAG,patients with coronary artery stenosis less than 50%(n=264 cases)were included into the control group,and patients with coronary artery stenosis equal or more than 50%(n =471 cases)were included into the CHD group.According to the clinical diagnosis,patients in the CHD group were divided into acute coronary syndrome(ACS)group(n = 366 cases)and stable coronary heart disease group(n =105 cases).Clinical data of the three groups of patients were collected,and MHR and CLEL were calculated based on the first fasting blood routine and lipid test results after admission and comparison of clinical data.Patients in the CHD group were assigned a SYNTAX score based on CAG results,and were classified into a low-risk group(n = 316 cases)with a SYNTAX score of ≤ 22,and a high-risk group of >22(n=155 cases).The differences of clinical data,MHR and CLEL between the two groups were analyzed.And also the correlation between MHR,CLEL and SYNTAX scores in patients with CHD were analyzed.Finally,ROC curve was used to analyze the diagnostic value of MHR and CLEL for CHD.Results(1)The differences were statistically significant(P <0.05)in the age,systolic pressure,the proportion of history of hypertension,the proportion of history of diabetes mellitus,the proportion of history of hyperlipidemia,WBC,NEUT,MONO[(0.46 ±0.16)vs(0.41 ± 0.13)],Cr,UA,FBG,CK-MB,BNP,hs-TNT,MHR[(0.45 ± 0.19)vs(0.37 ± 0.15)],CLEL[(166.65 ± 55.68)vs(154.20 ± 43.40)] of patients in the stable coronary heart disease group compared with the control group;And the differences were statistically significant(P < 0.05)in the age,male ratio,proportion of smoking history,proportion of history of hypertension,proportion of history of diabetes mellitus,WBC,NEUT,MONO[(0.59 ± 0.37)vs(0.41 ± 0.13)],Urea,Cr,UA,TC,apo A1,apo B,LPa,FBG,CK,CK-MB,BNP,hs-TNT,MHR[(0.58±0.40)vs(0.37 ± 0.15)],CLEL[(173.26 ± 58.38)vs(154.20 ± 43.40)] of patients in the ACS group compared with the control group;And the differences were statistically significant(P <0.05)in male ratio,systolic pressure,diastolic pressure,the proportion of smoking history,WBC,NEUT,LYMPH,MONO[(0.59 ± 0.37)vs(0.46 ± 0.16)],Cr,apo A1,CK,CK-MB,BNP,hs-TNT,MHR[(0.58 ± 0.40)vs(0.45 ± 0.19)] of patients in the ACS group compared with the stable coronary heart disease group.(2)The differences were statistically significant(P < 0.05)in systolic pressure,diastolic pressure,the proportion of history of hyperlipidemia,WBC,NEUT,LYMPH,MONO[(8.05 ± 3.95)vs(5.65 ± 3.11)],RBC,HDL-C[(0.99 ± 0.22)vs(1.16 ±0.36)],apo A1,CK,CK-MB,BNP,hs-TNT,MHR[(0.80 ± 0.49)vs(0.43 ± 0.20)],CLEL [(210.26 ± 61.65)vs(152.92 ± 45.17)] of patients in high-risk group compared with low-risk group.(3)MHR increases as coronary SYNTAX score increases and is positively correlated with SYNTAX score(r = 0.575,P < 0.05);and also CLEL increases as coronary SYNTAX score increases and is positively correlated with SYNTAX score(r = 0.494,P < 0.05).(4)The cut-off point value of MHR to diagnostic CHD is 0.528,with the sensitivity of 43.52% and with the specificity of 85.98% and with area under the curve of 0.689;The cut-off point value of CLEL to diagnostic CHD is 162.98,with the sensitivity of54.56%,and with the specificity of 61.36%,and with area under the curve area of 0.59.Conclusion MHR and CLEL are positively correlated with coronary SYNTAX score in CHD patients and they may be as predictive index for the severity of coronary atherosclerosis lesion and have certain diagnostic value for CHD. |
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