Correlation Analysis Of Peripheral Blood Neutrophil-lymphocyte Ratio And Vulnerability Of Coronary Plaque

Objective: By analyzing the change level of neutrophil-lymphocyte(NLR)ratio in blood of selected patients,quantitative and qualitative analysis of coronary plaque was performed by intravascular ultrasound(IVUS),and the correlation between NLR and vulnerability of coronary plaque was explored.Methods: From June 2017 to January 2019,100 patients who underwent coronary angiography(CAG)and intravascular ultrasound(IVUS)examination were selected.Among them,60 were male patients and 40 were female patients,with an average age of(64.16±7.58 years).General information such as sex,age,smoking,hypertension and history of diabetes mellitus were obtained routinely.Fasting venous blood was taken early the next morning after admission.The white blood cell count,classification and NLR value were analyzed and calculated by automatic blood analyzer.The plaque was quantitatively analyzed by i MAP-intravascular ultrasound imaging system.The minimum lumen area of coronary artery,the area of extravascular elastic membrane of lesion and reference segment,the diameter of the thickest plaque and the thinnest plaque on the opposite side were measured.The plaque load,reconstruction index and eccentricity index were calculated.Qualitative analysis can get the percentage of various plaque components and their total area.According to IVUS results,48 cases were divided into stable plaque group and 52 cases into vulnerable plaque group.Statistical analysis is carried out by SPSS 20.0 statistical software.Result:1.General data comparison: There was no significant difference in age and sex between the two groups(p > 0.05).BMI index was not significantly different between vulnerable plaque group and stable plaque group(p > 0.05).The proportion of hypertension and diabetes mellitus was 47.6% and 57.1% in stable plaque group,50.0% and 60.3% in vulnerable plaque group,but there was no significant difference (p > 0.05).The number of smokers in vulnerable plaque group was higher than that in stable plaque group,but there was no significant difference between the two groups(p > 0.05).2.Quantitative analysis showed that lumen area and plaque load in vulnerable plaque group were higher than those in stable plaque group,but there was no significant difference(p > 0.05);vascular remodeling index and plaque eccentricity index in vulnerable plaque group were significantly higher than those in stable plaque group,with statistical significance(p < 0.05).3.Qualitative analysis showed that the necrosis core of vulnerable plaque group was significantly higher than that of stable plaque group,with statistical significance(p <0.05);the fibrous tissue,fibrous adipose tissue and calcified tissue of vulnerable plaque group were significantly lower than those of stable plaque group,with statistical significance(p < 0.05).4.Leukocyte classification and count comparison between the two groups: Leukocyte count,central granulocyte count and basophil count in vulnerable plaque group were higher than those in stable plaque group,but there was no significant difference(p >0.05);Eosinophil count and lymphocyte count in vulnerable plaque group were lower than those in stable plaque group,but there was no significant difference(p > 0.05);NLR level in vulnerable plaque group was lower than that in stable plaque group.Significantly higher than the stable plaque group,with statistical significance(p <0.05).5.The correlation analysis between NLR and IVUS: Spearman correlation analysis showed that NLR was positively correlated with remodeling index,eccentricity index and necrosis core of coronary artery lesions,with correlation coefficients of r=0.216,0.245 and 0.486(p < 0.05),while NLR was negatively correlated with fibrous tissue,fibrous adipose tissue and calcified tissue,with correlation coefficients of r=-0.349,-0.283 and-0.255(p < 0.05).Conclusion:1.The vulnerability of coronary atherosclerotic plaque is correlated with clinical NLRlevel.2.Clinical IVUS examination combined with changes of NLR level in peripheral blood may be helpful in the diagnosis of vulnerable plaques in coronary artery.