Changes Of Neutrophil To Lymphocyte Ratio,platelet To Lymphocyte Ratio And Mean Platelet Volume And Correlation With Acute Coronary Syndrome

Objective:To study the changes of neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)and mean platelet volume(MPV)in patients with acute coronary syndrome(ACS)and their correlation with the severity of coronary artery disease,and to explore the predictive value of NLR、PLR、MPV for ACS patients.Methods:A total of 376 patients who underwent coronary angiography in the Department of Cardiology,the second hospital of Shanxi Medical University from July 2019 to July 2020were divided into ACS group(n=249)and control group(n=127).According to Gensini score(GS),ACS group was divided into three subgroups,there were 81 cases in mild lesions(GS<20 points),83 cases in moderate lesion group(20≤GS<44 points)and 85cases in severe lesion group(GS≥44 points).The independent risk factors of ACS were screened by multivariate logistic regression.The differences of NLR,PLR and MPV between mild,moderate and severe coronary lesions groups and the correlation between NLR,PLR and MPV and the severity of coronary lesions were compared between the two groups.The optimal reference value of the diagnostic ACS was obtained by the working characteristics(ROC)curve of the subjects and the diagnostic value of different indexes was compared.Results:(1)There were significant differences in age,male ratio,smoking history,hypertension history,diabetes history,white blood cell count,neutrophil count,lymphocyte count,platelet count,alanine aminotransferase,aspartate aminotransferase,creatinine,albumin,uric acid,troponin I,Gensini score,left ventricular ejection fraction,glomerular filtration rate,NLR,PLR,MPV(P<0.05).There was no significant difference in triglyceride,total cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol,urea nitrogen and body mass index(P>0.05).(2)Age,male ratio,smoking history,hypertension history,diabetes history,Gensini score,uric acid,troponin I,left ventricular ejection fraction,NLR,PLR and MPV were independent risk factors for ACS(P<0.05).(3)There were significant differences in NLR,PLR and MPV among mild,moderate and severe coronary lesions(P<0.05),and there were significant differences in multiple comparisons between groups(P<0.05).(4)NLR,PLR and MPV were positively correlated with Gensini score(r_n=0.783,r_p=0.745,r_m=0.682,P<0.05).(5)The best cut point of NLR for predicting ACS is 2.57,sensitivity is 61%,specificity is 88.2%,area under the curve(AUC)is 0.797(95%CI:0.753-0.841,P<0.05);The best cut point of PLR for predicting ACS is 106.33,sensitivity is 70.3%,specificity is 89.8%,and AUC is 0.859(95%CI:0.821-0.896,P<0.05);The best cut point for MPV to predict ACS is 8.65f L,sensitivity is 54.6%,specificity is 83.5%,and AUC is0.750(95%CI:0.700-0.799,P<0.05);The difference in the area under the curve between PLR and NLR and MPV was statistically significant(P<0.05);the difference in the area under the curve between NLR and MPV was not statistically significant(P>0.05).Conclusions:The NLR、PLR and MPV levels of ACS group were increased,which was positively correlated with the severity of coronary artery disease.The three indexes,as independent risk factors of ACS,had better diagnostic performance and the highest diagnostic efficacy of PLR.