Feasibility Analysis Of Whole Blood Cell Count Evaluating Carotid Atherosclerosis

Background:Cardiovascular and cerebrovascular diseases are common diseases that threaten human health and life.They are called three major fatal diseases of human beings together with malignant tumors,which seriously affect the survival and prognosis of patients,and bring a heavy burden to society and families.The incidence of cardio-cerebral vascular disease(CVD)has been increasing in recent years accompanied by the change of lifestyle and the aging of the population.The disability and mortality stay increasing.Therefore,early diagnosis and treatment would be the key for prevention and control of CVD.Atherosclerosis is the main pathological basis of CVD.It would be benificial for CVD patients to find and intervene therosclerosis early that includes delaying occurrence and progression of CVD,improving the quality of those patients.Carotid is usually involved by atherosclerosis which is often considered a window for observing coronary and cerebral arteries as well as systemic atherosclerosis.The evaluation of carotid atherosclerosis(CAS)could reflect the degree of CVD indirectly.Whole blood cell count is an easy,inexpensive routine blood test.Including: mean corpuscular volume(MCV),red blood cell distribution width(RDW),mean erythrocyte hemoglobin(MCH),mean erythrocyte hemoglobin concentration(MCHC),platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW),plateletcrit(PCT),white blood cell count(WBC),neutrophil count(NE),monocyte count(MO),lymphocyte count(LYM)and so on.Many studies have found that the whole blood count has a certain correlation with the occurrence,progression and prognosis of CVD.However,there is still controversy in this research area,which needs to be further explored.Objective:To analyze the correlation between whole blood count and CAS,explore its value and feasibility in the assessment of CAS risk,and provide clinical ideas for early screening and early intervention of patients with atherosclerosis.Method:468 subjects who underwent physical examination and performed carotid ultrasonography at the Physical Examination Center of The First Hospital of Jilin University from June 2016 to June 2018 were selected according to the inclusion and exclusion criteria.Collect relevant baseline data for all subjects in a complete and detailed manner.The whole blood cell count and blood biochemical indicators were examined.The 468 cases were classified into two groups according to carotid intima-media thickness(IMT).Group I: normal carotid artery group(111 cases),group II: carotid atherosclerosis group(357 cases).The t-test,rank sum test and chi-square test were used to compare the whole blood cell count,blood biochemical indicators and other related factors between the two groups.Spearman correlation analysis was used to explore the correlation between whole blood cell count,blood biochemical indicators and other parameters and carotid IMT.Multivariate logistic regression analysis was used to analyze the risk factors of carotid atherosclerosis.All tests were performed on two sides.The difference was statistically significant at P < 0.05.Result:(1)The ratio of male,age,the prevalence rate of hypertension and coronary heart disease,the ratio of smoking,waist circumference,systolic blood pressure,MCV,WBC,NE,fasting blood glucose(FBG),creatinine(CRE)and blood urea nitrogen(BUN)in the carotid atherosclerosis group were higher than the normal carotid artery group,the difference was statistically significant(P<0.05).(2)The analysis on the correlation between carotid IMT and clinical parameters showed that carotid IMT was positively correlated with age(r=0.278,P<0.001),systolic blood pressure(r=0.196,P<0.001),waist circumference(r=0.148,P=0.001),MCV(r=0.106,P=0.022),RDW(r=0.158,P=0.001),WBC(r=0.128,P=0.006),MO(r=0.108,P=0.019),NE(r=0.138,P=0.003),FBG(r=0.118,P=0.011)and CRE(r=0.126,P=0.006),but negatively correlated with high density lipoprotein-cholesterol(HDL-C)(r=-0.132,P=0.004).(3)Multivariate logistic regression analysis of factors affecting carotid atherosclerosis showed that MCV(OR=1.135,P=0.041,95% CI: 1.005 to 1.282),low density lipoprotein-cholesterol(LDL-C)(OR=1.404,P=0.046,95% CI: 1.006 to 1.960),age(OR=1.070,P<0.001,95% CI: 1.036 to 1.106)and the ratio of smoking(OR=3.082,P=0.003,95%CI: 1.468 to 6.473)were independent risk factors of carotid atherosclerosis.Conclusion:(1)Among whole blood cell count,MCV,RDW,WBC,NE,MO are positively correlated with carotid IMT.The higher level of them,the higher the risk of atherosclerosis.Whole blood cell count can be used to evaluate the risk of CAS.(2)Increased MCV is an independent risk factor for CAS,indicating that the occurrence and progression of carotid atherosclerosis are closely related to MCV.Regular MCV testing is benificial for the early detection of high-risk atherosclerosis,which is of great significance in delaying the occurrence and progression of atherosclerosis.