| Research background:Coronary atherosclerotic heart disease(CHD)is the leading cause of death worldwide.With the continuous improvement of people’s economic level and quality of life,the incidence of CHD is also accelerating.Specifically,it may be due to the increase in consumption of poor quality meals and commodities;an increase in bad habits such as smoking,heavy drinking,and sedentary pastimes;decreased physical activity;and the rising trend of obesity,so early prevention of CHD is especially important for us.Numerous studies have shown that atherosclerosis(AS)is one of the main causes of CHD,and its possible pathogenic mechanism is related to lipid metabolism disorders and poor immune response,resulting in chronic inflammation of arterial walls.Current studies have pointed out that some inflammatory markers play an important role in the prediction and diagnosis of CHD.Neutrophilic granulocyte(NEUT)plays an important role in a series of occurrences and development such as atherosclerosis,thrombosis and acute coronary syndrome(ACS).The association between high-density lipoprotein cholesterol(HDL-C)and the risk of cardiovascular disease has been well documented,with antioxidant,anti-inflammatory,anti-apoptotic properties(inhibition of apoptosis of endothelial cells)and other functions.However,in current studies,there are few studies on the ratio of neutrophils to high-density lipoprotein cholesterol(NHR)to the occurrence and development of CHD.In addition,uric acid(UA)can affect lipid metabolism,reduce nitric oxide formation,promote the proliferation of vascular smooth muscle cells(VSMCs),increase inflammatory response,and thus promote the formation of AS.Hypoalbuminemia can increase blood viscosity,disrupt endothelial function,and reduce antioxidant capacity.Previous studies have shown that uric acid and albumin single indexes have been studied more on the correlation of CHD,while the ratio of uric acid to albumin(UAR)combining the two has limited research,and it may have higher sensitivity for the assessment of inflammatory states than a single index.At present,there are few studies on the correlation analysis between NHR,UAR and coronary heart disease at home and abroad,and the above indicators are easy to detect,which can provide a theoretical basis for the early diagnosis of CHD in areas with lack of funds and backward technology in China,and explore whether it can predict the degree of coronary heart disease and coronary artery lesions.Objective:This study investigated the correlation between NHR and UAR and CHD and coronary disease severity.Research method:A retrospective collection of 513 patients hospitalized in our hospital from March 1,2021 to June 1,2022 was collected,of which 370 patients confirmed by coronary angiography were listed as coronary heart disease group,and 143 patients who underwent coronary angiography during the same period were not found to be significantly abnormal.The general information and corresponding biochemical indexes of patients were collected,NHR and UAR values were calculated,and NHR,UAR,and serum test indicators of the two groups of patients were compared.According to the GS score,patients with coronary heart disease were divided into three groups,140 cases in the mild risk group(1-30 points),134 cases in the intermediate risk group(31-60 points),and 96 cases in the severe risk group(> 60 points),and the NHR and UAR levels between the three groups were compared and their correlation with coronary artery severity was analyzed.The correlation coefficient of Spearman was used to analyze the correlation between NHR,UAR and Gensini scores.In order to determine the risk factors associated with CHD,the univariate logistic regression model was first used to explore the rough correlation between coronary heart disease and various factors,and then the multivariate logistic regression model included factors that were important in the univariate model to determine the relevant factors independent of the existence of coronary heart disease,analyze whether NHR and UAR are independent risk factors for coronary heart disease,and further analyze NHR,The predictive value of UAR for CHD.Research results:1.According to the contrast results,they were divided into coronary heart disease group and control group,and the basic clinical data and serological indicators of the two groups were compared,among which there were statistical differences in gender,age,diabetes history,smoking history,HDL,LDL,NEUT,UA,ALB,WBC,NHR,UAR,P<0.05,while hypertension,BMI,TC,TG,Cr,BUN,the difference was not statistically significant,P>0.05.2.According to the GS score results,all patients in the coronary heart disease group were divided into low-risk group(1-30 points),intermediate-risk group(31-60 points),and high-risk group(> 60 points),and there were no significant differences in gender,age,smoking history,BMI,TC,TG,CR and BUN,P>0.05,and there were statistical differences in hypertension,diabetes,HDL,LDL,NEUT,UA,ALB,WBC,NHR,UAR,UAR,P<0.05.3.According to Spearman correlation analysis,NHR,UAR and Gensini scores were positively correlated,and the r values were respectively 0.394 and 0.745,P< 0.05.4.Multivariate Logistic regression model analysis of the collected indexes showed that NHR was an independent risk factor for the onset of CHD(OR: 3.238,95CI: 2.328-4.505,P <0.001),and UAR was an independent risk factor for the incidence of CHD(OR: 2.597,95CI: 1.960,3.442,P <0.001).5.NHR,UAR and their combined predictors have diagnostic value for coronary heart disease,and the areas under the ROC curve are respectively 0.842 [95% CI(0.806,0.877)],0.879 [95% CI(0.847,0.911)],and 0.919 [95% CI(0.895,0.944)].Conclusions:From this study,it was concluded that.(1)NHR and UAR are independent predictors for the diagnosis of coronary heart disease.(2)There was a positive correlation between NHR and UAR levels and GS scores.The higher the level of NHR and UAR,the more severe the coronary lesion may be. |
