| Objective:To explore the relationship between monocyte count/high density lipoprotein cholesterol ratio(MHR)and the severity of coronary heart disease and coronary artery disease,for the diagnosis and treatment of clinical coronary heart disease and the evaluation of the severity of coronary artery disease provide reference basis.Methods:1.Screening patients with chest pain in the Department of Cardiovascular,Yanbian University hospital from January 2019 to December 2019.Among them,306 patients with coronary heart disease(CHD)who were diagnosed with coronary heart disease(CHD)after coronary angiography(CAG)were selected as the research objects,and they were divided into As the coronary heart disease group,patients(92 cases)who showed no stenosis during the same period of coronary angiography were selected as the control group.According to CAG results,the coronary heart disease group was divided into low-risk group(112 cases),intermediate-risk group(93 cases),and high-risk group(101 cases)by calculating SYNTAX score.2.Collect and record general clinical data of selected patients,gender,age,weight,height,blood pressure,smoking history,medication history(antiplatelet drugs,angiotensin converting enzyme inhibitor(ACEI),angiotensin receptors)Antagonists(angiotensin receptor blocks,ARB),calcium channel blockers(calcium channel blocker,CCB,β-receptor blockers,etc),combined diseases(hypertension,diabetes,lipid abnormalities),etc.At the same time,collect and record the blood routine,blood lipids,blood sugar,liver function,kidney function,high-sensitivity C-reactive protein and other biochemical indicators of all patients in the group,and according to the blood routine mononuclear cell count(unit 10^9/L)and the blood lipid test Low density lipoprotein cholesterol(low density lipoprotein cholesterol,HDL-C)(unit mmol/L)ratio of the two to calculate the MHR.3.Use statistical analysis methods to compare the relevant data between the coronary heart disease group and the control group,and the low,medium,and high risk groups of coronary heart disease.The research focuses on the difference between MHR in coronary heart disease and the control group,and the difference between MHR and the control group.SYNTAX score relationship.Further evaluate the significance of MHR through ROC curve and Logistic regression analysis.Results:1.Comparison between the coronary heart disease group and the control group:the MHR value of the coronary heart disease group was higher than that of the control group(0.27(0.20-0.44);0.34(0.23-0.48),P<0.043),the difference was statistically significant(P<0.05).2.Comparison of coronary heart disease between groups: The comparison result showed that the MHR level increased with the increase of SYNTAX score(0.25(0.16-0.31);0.34(0.21-0.44);0.51(0.41-0.70),P<0.001),the difference was statistically significant Significance(P<0.05).3.MHR is positively correlated with inflammatory indicators such as white blood cell count,neutrophil count,lymphocyte count,monocyte count,and high-sensitivity C-reactive protein.4.The ROC curve analysis of MHR in the diagnosis of coronary heart disease:the area under the curve is 0.570(95%CI: 0.520-0.637),the cut-off value is 0.29,the sensitivity is 61.44%,and the specificity is 56.52%.ROC curve analysis for MHR diagnosis of coronary heart disease(high risk): the area under the curve is 0.799(95%CI: 0.736-0.862),the cut-off value is 0.32,the sensitivity is 88.12%,and the specificity is 60.87%.5.Logistic regression analysis of MHR on the risk factors of coronary heart disease: Coronary heart disease: The risk of coronary heart disease in the high quantile group of MHR without adjustment is 1.923 times that of the low quantile group(95%CI: 1.201-3.079),adjusted for age,Gender,blood pressure,Platelets,low-density lipoprotein cholesterol,fasting blood glucose,glycosylated hemoglobin,aspartate aminotransferase,alanine aminotransferase,albumin,creatinine,high-sensitivity C-reactive protein and other factors,the risk disappears.Coronary heart disease high-risk group: The risk of high-risk coronary heart disease in the high-quartile MHR group without adjustment is 11.025 times that of the low-quartile group(95%CI:5.298-22.941),adjusted for age,gender,blood pressure,Platelets,low-density lipoprotein cholesterol,fasting blood glucose,glycosylated hemoglobin,aspartate aminotransferase,alanine aminotransferase,albumin,creatinine,high-sensitivity C-reactive proteinand and other factors are 5.147 times that of the low quantile group(95%CI: 1.941=13.650).Conclusion:1.MHR is related to coronary heart disease and has a certain predictive effect on the diagnosis of coronary heart disease.2.MHR is correlated with the severity of coronary artery disease and is an independent risk factor for severe coronary artery disease. |
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