| BackgroundWith China's economic development and improvement of living standards,the average life expectancy of the people is constantly increasing.Under the trend of population aging,the incidence and mortality of chronic diseases such as coronary heart disease and diabetes are increasing year by year.Prognostic assessment becomes an important public health issueThe pathogenesis of coronary heart disease is based on atherosclerosis,plaque damage,rupture,platelet aggregation,thrombosis,narrowing or occlusion of coronary lumen,causing acute or chronic myocardial ischemia.Inflammatory cells,dyslipidemia,impaired glucose tolerance,coagulation and fibrinolytic system disorders play important roles at all stages.Type 2 diabetes,as one of the important and independent risk factors for coronary heart disease,can increase the level of oxidative stress,reduce the content of nitric oxide,affect calcium regulation,activate platelets,and thereby promote the progress of atherosclerosis.Therefore,coronary heart disease in elderly patients with coronary heart disease with type 2 diabetes is more severe than patients without type 2 diabetes,and the degree and scope of accumulation are greater.Peripheral blood platelet to lymphocyte ratio(PLR),as a newly proposed inflammatory marker,is economical,convenient and fast in clinical research.Several studies have shown that PLR is closely related to the prognosis of coronary heart disease patients and the severity of coronary artery disease.And PLR has a good predictive effect on the occurrence of type 2 diabetes and its complications(diabetic nephropathy,diabetic retinopathy)At present,SYNTAX score is often used as an index of coronary heart disease risk stratification to evaluate the prognosis of patients with coronary heart disease.Many big data studies have shown that the SYNTAX score can assess the degree of coronary artery lesions in detail,and can better predict the risk of recirculation,stent thrombosis and MACE after PCI,especially for patients with multiple coronary artery disease.Can help clinicians better choose the best treatment options.Existing studies have shown that PLR is closely related to the degree of coronary artery disease,and the level of glycated hemoglobin can also affect the severity of coronary artery disease.However,there are few related studies on the relationship between PLR and SYNTAX score in the elderly.In this study,the elderly patients with coronary heart disease and type 2 diabetes were used as the research object.The relationship between the PLR level and the SYNTAX score and the correlation between the glycated hemoglobin level and the SYNTAX score will be discussed in depth.Provide a certain basis for the treatment and prognosis of patients with coronary heart disease and type 2 diabetes.Research purpose1.Relationship between platelet to lymphocyte ratio and severity of coronary artery disease in elderly patients with coronary heart disease and type 2 diabetes2.Correlation between glycated hemoglobin level and severity of coronary artery diseaseObjects and MethodsFrom January 2019 to November 2019,120 elderly patients undergoing coronary angiography who underwent coronary angiography in the Department of Cardiology,Southern Hospital,First Affiliated Hospital of Southern Medical University,were selected as the research objects,and the patients were divided into three groups based on the examination results and the combined diseases:A Group(32 patients with normal coronary angiography and no diabetes),Group B(50 patients with coronary heart disease without diabetes),and Group C(38 patients with coronary heart disease accompanied by diabetes).The patients were then classified according to the degree of coronary artery disease SYNTAX score.They were divided into normal coronary artery group(32 cases),low-risk group(SYNTAX score<23 points and 67 cases),and middle and high-risk group(SYNTAX score>23 points and 21 cases).Blood routine(calculated PLR),glycated hemoglobin were measured after admission(HbAlc),uric acid(UA),creatinine(GR),low-density lipoprotein(LDL-C),C-reactive protein(CRP)and other biochemical indicators;coronary angiography was performed to calculate the SYNTAX score.Finally,SPSS software was used for statistical testing,linear correlation and regression,and risk factor analysis.Results1.There are statistical differences in the values of sex ratio,prevalence of hypertension,WBC,NEU,FPG,HbA1c,UA,GR,HDL-C,CRP,cTnl between the three groups of groups A,B and C(P<0.05).There were statistically significant differences in the values of sex ratio,prevalence of hypertension,PLT,PLR,FPG,HbAlc,UA,GR,and CRP among the three groups of normal coronary arteries,low-risk groups,and middle and high-risk groups(P<0.05).2.There is a positive correlation between PLR level and coronary SYNTAX score(r=0.356,P=0.001),regression equation:Y=6.787(? intercept)+0.068(?regression coefficient)X+?(residual error)(F=12.014,P=0.001)were statistically significant.3.HbAlc level was positively correlated with coronary SYNTAX score(r=0.210,P=0.05),but the regression equation was not statistically significant.4.After multivariate logistic regression analysis,glycated hemoglobin(P=0.027,OR=2.835),and uric acid(P=0.027,OR=1.009)were among the low-risk groups of coronary artery disease.Risk factors;PLR(P=0.035,OR=1.033)and glycated hemoglobin(P=0.023,OR=63.365)were risk factors in the middle-high risk group of coronary artery disease.Conclusions1.The PLR value is positively correlated with the coronary SYNTAX score,and the regression equation is statistically significant,that is,the higher the patient's PLR level,the more severe the coronary artery disease2.The level of HbAlc is positively correlated with the coronary SYNTAX score,but the regression equation is not statistically significant.The relationship between the two needs to be further confirmed by further multicenter and large sample studies.3.Multivariate regression analysis after adjusting for confounding factors showed that PLR was an independent risk factor for the medium-high risk group of coronary artery disease;glycated hemoglobin was an independent risk factor for coronary artery disease. |
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