| ObjectiveThe ratio of neutrophils to lymphocytes and the level and significance of serum lipoprotein-associated phospholipase A2 in patients with type 2diabetes mellitus complicated with coronary heart disease.Methods In this study,retrospective comparative analysis of cases was selected.Patients with type 2 diabetes mellitus(T2DM)and coronary atherosclerotic heart disease(CAD)were diagnosed and diagnosed in Taizhou people’s Hospital from 2017 to 2020,excluding patients with recently confirmed infection and elevated body temperature;patients with NYHA and / or Killip grade Ⅲ or Ⅳ;patients with congenital heart disease;patients with vascular embolism except cardio-cerebral vessels;patients with chronic inflammatory(chronic consumption)diseases.Patients with blood diseases,tumors and unknown causes affecting blood cell count;patients with severe liver and renal dysfunction;stage 3 or more of diabetic nephropathy;stage 3 or more of diabetic retinopathy;patients with other endocrine diseases such a shyperthyroidism,hypothyroidism,Cushingsyndrome,pheochromocytoma,etc.;pregnant and lactating women.Patients with non-coronary heart diseases such as aortic dissection,myocarditis,cardiomyopathy,valvular disease,pulmonary embolism,cerebral hemorrhage and acute stroke,and other types of diabetes.Patients who underwent coronary angiography due to symptoms of cardiac discomfort without stenosis,type 2 diabetes and excluded from the above exclusion criteria were included.The patients were divided into CAD group,T2 DM group,T2DM+CAD group and healthy control group,The basic statistical method calculates the statistically significant minimum sample size,expands the number of subjects as much as possible,and finally determines 80 patients in each group.The general data of the patients were collected,such as sex,age,height and weight,past history of body mass index(BMI),hypertension,stroke,peripheral vascular disease,dyslipidemia,family history of premature coronary heart disease,etc.The relevant clinical data such as fasting blood glucose,glycosylated hemoglobin,serum creatinine,urea nitrogen,cholesterol,triglyceride,low density lipoprotein,high density lipoprotein,white blood cell count,neutrophil count,lymphocyte count and other clinical biochemical data were recorded and counted.Each patient underwent coronary angiography(CAG),and the Gensini score was calculated according to the results of coronary angiography.Serum lipoprotein associated phospholipase A2(Lp-PLA2)was measured and the ratio of neutrophils to lymphocytes(NLR)was calculated to compare the differences of Lp-PLA2 and NLR among groups.Results1.Compared with healthy control group,the levels of NLR and Lp-PLA2 in T2DM+CAD,CAD group and T2 DM group were significantly increased(p<0.05);Compared with CAD group and T2 DM group,the levels of NLR and Lp-PLA2 in T2DM+CAD group were significantly increased(p<0.05).;2.According to Pearson’s related processing and analysis data,the results: Lp-PLA2 and NLR are positively correlated(r=0.348,p< 0.001);it can be seen that Lp-PLA2 and NLR have a good correlation with the risk of T2 DM and CAD,and they are independent of T2 DM complicated by CAD.Risk factors(p<0.05);3.ROC curve analysis: Lp-PLA2 and NLR have a certain diagnostic value for the risk of coronary heart disease in patients with type 2 diabetes mellitus.4.This study also found that the T2DM+CAD group had a higher systolic blood pressure level than the other three groups(p < 0.05);the Gensini score of the CAD group was significantly lower than that of the T2DM+CAD group(p<0.05).Conclusions1.Patients with type 2 diabetes mellitus complicated with coronary heart disease have higher levels of Lp-PLA2 and NLR,and there is a significant correlation between them;2.Elevated Lp-PLA2 and NLR are independent risk factors of coronary heart disease in patients with type 2 diabetes mellitus,and have certain diagnostic value in patients with type 2 diabetes mellitus complicated with coronary heart disease. |
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