摘要
目的 探究外周血血小板/淋巴细胞比值(PLR)与成人急性冠状动脉综合征(ACS)患者冠状动脉病变程度的关系,为临床诊断及病情评估提供依据.方法 本研究为回顾性研究.按照纳入与排除标准,搜集2018年1月—2021年8月经冠状动脉造影及临床症状诊断为ACS的患者260例为观察组,随机选取同期入院排除ACS的患者60例为对照组.观察组按照Gensini评分又分为轻度组(34例)、中度组(105例)与重度组(121例).比较组间患者的临床资料及实验室相关指标水平差异.计量资料中符合正态分布的采用t检验,非正态分布的采用Kruskal-Wallis H秩和检验,计数资料采用χ2检验,采用受试者工作特征(ROC)曲线评估PLR对ACS的诊断价值.结果 观察组患者的高血压、高脂血症、吸烟史的占比与对照组比较差异显著,均有统计学意义(P均＜0.05);两组实验室指标中白细胞、中性粒细胞、淋巴细胞、血小板、中性粒细胞/淋巴细胞比值、血小板/中性粒细胞比值、血小板/白细胞比值及PLR比较,差异均有统计学意义(P均＜0.05).轻度组、中度组和重度组患者的白细胞、中性粒细胞、中性粒细胞/淋巴细胞比值及PLR差异均有统计学意义(P均＜0.05).PLR诊断ACS的AUC为 0.761(95%CI:0.706～0.816),最佳截断值为 126.45,敏感度 58.1%,特异度 90.0%.结论 PLR对于成人急性冠状动脉综合征具有重要的辅助诊断价值.
Abstract
Objective To explore the relationship between the platelet-to-lymphocyte ratio(PLR)in peripheral blood and the severity of coronary artery lesions in adults with acute coronary syndrome(ACS),providing a basis for clinical diagnosis and disease evaluation.Methods This study was a retrospective study.According to inclusion and exclusion criteria,260 patients diagnosed with ACS based on coronary angiography and clinical symptoms from January 2018 to August 2021 were included as the observation group,and 60 randomly selected patients admitted during the same period without ACS were included as the control group.The observation group was further divided into mild group(34 cases),moderate group(105 cases),and severe group(121 cases)groups based on the Gensini score.The differences in clinical data and laboratory related indicators between the groups were compared.For normally distributed quantitative data,the t-test was used;for non-normally distributed data,the Kruskal-Wallis H test was used;and for count data,the χ2 test was used.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of PLR for ACS.Result The proportion of hypertension,hyperlipidemia,and smoking history in the observation group were significantly different from those in the control group,and all had statistical significance(all P＜0.05).Laboratory indicators,including white blood cells,neutrophils,lymphocytes,platelets,neutrophil-to-lymphocyte ratio,platelet-to-neutrophil ratio,platelet-to-white blood cell ratio,and PLR,showed significant differences between the two groups(all P＜0.05).Significant differences in white blood cells,neutrophils,neutrophil-to-lymphocyte ratio,and PLR were observed among the mild,moderate,and severe groups(all P＜0.05).The AUC of PLR for diagnosing ACS was 0.761(95%CI:0.706～0.816),with an optimal cutoff value of 126.45,sensitivity of 58.1%,and specificity of 90.0%.Conclusion PLR has important auxiliary diagnostic value for adult ACS.
维普
万方数据