| Objective:Compare the changes of platelet/lymphocyte(PLR)and neutrophil/lymphocyte(NLR)in patients with coronary heart disease(CHD),and explore platelet/lymphocyte(PLR)and neutrophil/lymphocyte(NLR)in patients with coronary heart disease Relationship with the degree of coronary artery stenosis.Methods:Selected 357 patients with coronary angiography(CAG)who were hospitalized for the first time from August 2019 to August 2020 in the Affiliated Hospital of Qingdao University.Collect medical records such as height,gender,weight,age,diabetes history,smoking history,hypertension history,etc.,and sign an informed consent form.According to CAG results,they were divided into 261 cases of coronary heart disease group and 96 cases of non-coronary heart disease group.The changes of NLR,PLR,blood lipids and inflammatory cells were compared between the two groups.The congenital heart disease group was divided into 2 groups according to the syntactic score.Among them,22 cases with the highest syntactic score were the low-risk group(n=138),and the middle-high-risk group with 22 points or more(n=122).Compare the differences of NLR,PLR,blood lipids and inflammatory cells in each group,and use pearson to analyze the correlation between PLR,NLR and grammatical score.To explore whether PLR and NLR are single-factor and multi-factor risk factors for coronary heart disease,and perform logistic regression analysis.Then,use the method of drawing ROC curve to determine the critical point of each index for the diagnosis of coronary heart disease.Result:1.In the comparison of clinical data,the coronary heart disease group and the non-coronary heart disease group are statistically significant in terms of gender,smoking history,and hypertension history(P=0.001,0.008,0.016).BMI,age,and diabetes history were not statistically significant(P=0.253,0.800,0.608).Clinical data showed that the high-density lipoprotein cholesterol(HDL-C)and lymphocytes in the coronary heart disease group were lower than those in the non-coronary heart disease group,and the difference was statistically significant(P=0.000,0.038).The levels of cholesterol(LDL-C)neutrophils,platelets,NLR,PLR,and low-density lipoprotein in the coronary heart disease group were higher than those in the CHD group alone(P=0.000,0.001,0.000,0.000,0.049),the difference was statistically significant.The total cholesterol(TC),triglyceride(TG)and cholesterol of the two groups were significantly higher than those of the non-coronary heart disease group(P=0.000,0.001,0.000,0.049).There was no statistical difference in TC and TG(P=0.939,0.609).2.By comparing the general conditions of patients,it was found that there were statistical differences between the low-risk coronary heart disease group and the high-risk coronary heart disease group in smoking history,gender,history of hypertension,history of diabetes,and BMI(P=0.397,0.060,0.141,0.367,0.248).The age group was statistically significant(P=0.017).The lymphocytes in the low-risk group were significantly higher than those in the intermediate-risk group(P=0.000),and the difference was statistically significant.NLR,PLR,and neutrophils in the middle-high-risk coronary heart disease group were higher than those in the low-risk CHD group(P=0.000,0.000,0.000).There was no significant difference in TC,TG,HDL-C,LDL-C,and platelet content between the two groups(P=0.638,0.427,0.740,0.852,0.171).3.Using single-factor logistics analysis,LDL-C,HDL-C,and NLR are used as risk factors for coronary heart disease,and determined as single risk factors through multiple logistics regression analysis.4.NLR and PLR were positively correlated with SYNTAX score for CHD severity,with r values of 0.973 and 0.337,respectively(P<0.05).5.By drawing the ROC curve,the AUC of NLR was 0.926.The optimal diagnostic cut-off point of NLR for predicting CHD was 1.83,with a sensitivity of 87.3% and a specificity of 84.4%.The ROC curve of PLR was 0.648.The optimal diagnostic cut-off point of PLR for CHD prediction was 96.068,the sensitivity was 76.2%,and the specificity was 49%.The curve AUC of NLR combined with PLR for CHD prediction was 0.926,the best diagnostic cut-off point was 0.612,the sensitivity was 86.2%,and the specificity was 85.4%.6.The ROC curve of NLR was AUC=0.979.The optimal diagnostic cutoff point of high risk CHD predicted by NLR was 3.345,with sensitivity of 96.7% and specificity of89.9%.The ROC curve of PLR was 0.698.The optimal diagnostic cutoff point of PLR for predicting the severity of high-risk CHD was 139.117,the sensitivity was 60.7%,and the specificity was 71%.The curve AUC of NLR and PLR combined prediction of high-risk CHD was 0.979,the best diagnostic cutoff point was 0.350,sensitivity was 96.7%,specificity was 90.6%.Conclusion:1.Compared with non-CHD group,NLR,PLR,LDL-C was high and HDL-C was low in the CHD group.2.Compared with the low-risk CHD group,the age,neutrophils,NLR,PLR and lymphocytes were significantly increased in the high-risk CHD group.3.LDL-C,HDL-C,and NLR are independent risk factors for CHD,PLR is not an independent predictor of coronary heart disease,NLR,PLR are all related to the severity of coronary heart disease.4.NLR can be used as an inflammatory index for the diagnosis of CHD,and has a high value as a single prediction of CHD with medium and high-risk severity.Considering the low cost and easy measurement of blood routine,NLR is of great significance for clinical practice of primary medical care. |
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