中外医学研究2024，Vol.22Issue(22) ：142-146.DOI:10.14033/j.cnki.cfmr.2024.22.036

25-OH-D、WMR及NLR与女性早发冠心病患者冠状动脉病变程度及院内MACE的相关性

Correlation of 25-OH-D,WMR and NLR with the Degree of Coronary Artery Disease and In-hospital MACE in Female Patients with Early-onset Coronary Heart Disease

朱芩 杨茜 单晓兰 申立波
中外医学研究2024，Vol.22Issue(22) ：142-146.DOI:10.14033/j.cnki.cfmr.2024.22.036
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25-OH-D、WMR及NLR与女性早发冠心病患者冠状动脉病变程度及院内MACE的相关性

Correlation of 25-OH-D,WMR and NLR with the Degree of Coronary Artery Disease and In-hospital MACE in Female Patients with Early-onset Coronary Heart Disease

朱芩 1杨茜 1单晓兰 1申立波1
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作者信息

  • 1. 宁夏回族自治区人民医院 宁夏 银川 750004
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摘要

目的:探讨 25-羟维生素D(25-OH-D)、白细胞计数与平均血小板体积比值(WMR)及中性粒细胞与淋巴细胞比值(NLR)与女性早发冠心病患者冠状动脉病变程度及院内主要不良心血管事件(MACE)的相关性.方法:选择2020年1 月—2021 年 12 月宁夏回族自治区人民医院收治的 200 例女性冠心病患者作为研究组,根据发病年龄将研究组分为早发组(冠心病发病年龄≤65 岁,n=120)和非早发组(冠心病发病年龄>65 岁,n=80),同时选取年龄与早发组匹配的行冠状动脉造影示冠脉正常的健康女性 200 例作为对照组.采用Gensini评分评估冠状动脉病变严重程度,根据Gensini评分将早发组患者分为轻度病变组(≤30 分),中度病变组(31～60 分),重度病变组(>60 分),患者均检测 25-OH-D、WMR及NLR水平,比较对照组、早发组、非早发组 25-OH-D、WMR、NLR水平,比较轻度病变组、中度病变组、重度病变组 25-OH-D、WMR、NLR,分析 25-OH-D、WMR、NLR与院内MACE事件相关性.结果:非早发组WMR、NLR高于对照组、早发组,早发组WMR、NLR高于对照组,非早发组 25-OH-D低于对照组、早发组,早发组 25-OH-D低于对照组,差异有统计学意义(P<0.05);重度病变组WMR、NLR高于轻度病变组、中度病变组,中度病变组WMR、NLR高于轻度病变组,重度病变组 25-OH-D低于轻度病变组、中度病变组,中度病变组 25-OH-D低于轻度病变组,差异有统计学意义(P<0.05);相关性分析结果显示,25-OH-D与Gensini评分呈负相关(r=-0.386,P<0.05),WMR、NLR与Gensini评分呈正相关(r=0.674、0.621,P<0.05);所有患者均随访 12～24 个月,平均(15.65±1.98)个月,根据早发组患者是否发生MACE,将患者分为非MACE组 85 例和MACE组 35 例,MACE组WMR、NLR高于非MACE组,25-OH-D低于非MACE组,差异有统计学意义(P<0.05);多因素分析显示,WMR、NLR是发生MACE的危险因素,25-OH-D是发生MACE的保护因素(P<0.05).经受试者工作特征(ROC)曲线分析,25-OH-D、WMR、NLR联合评估敏感度、特异度均高于单一检测,且联合评估发生MACE的价值较高.结论:25-OH-D、WMR及NLR与女性早发冠心病患者冠状动脉病变程度及院内MACE事件存在明显的关联性,为女性冠心病患者冠状动脉病变程度及院内MACE事件评估提供有效依据.

Abstract

Objective:To investigate the correlation of 25-hydroxyvitamin D(25-OH-D),white blood cell count to mean platelet volume ratio(WMR)and neutrophil to lymphocyte ratio(NLR)and the degree of coronary artery disease and in-hospital major adverse cardiovascular events(MACE)in female patients with early-onset coronary heart disease.Method:A total of 200 female patients with coronary heart disease who admitted to People's Hospital of Ningxia Hui Autonomous Region from January 2020 to December 2021 were selected as the study group,the study group was divided into the early-onset group(age of onset of coronary heart disease≤65 years old,n=120)and the non-early-onset group(age of onset of coronary heart disease>65 years old,n=80)according to the age of onset,at the same time,200 healthy women with normal coronary angiography were selected as the control group.Gensini score was used to evaluate the severity of coronary artery disease,patients in the early-onset group were divided into the mild lesion group(≤30 scores),the moderate lesion group(31-60 scores)and the severe lesion group(>60 scores)according to Gensini score.The levels of 25-OH-D,WMR and NLR were detected in all patients,the levels of 25-OH-D,WMR and NLR in the control group,the early-onset group and the non-early-onset group were compared,the levels of 25-OH-D,WMR and NLR in the mild lesion group,the moderate lesion group and the severe lesion group were compared,the correlation between 25-OH-D,WMR,NLR and in-hospital MACE events was analyzed.Result:The WMR and NLR in the non-early-onset group were higher than those in the control group and the early-onset group,WMR and NLR in the early-onset group were higher than those in the control group,25-OH-D in the non-early-onset group was lower than that in the control group and the early-onset group,25-OH-D in the early-onset group was lower than that in the control group,the differences were statistically significant(P<0.05);the WMR and NLR in the severe lesion group were higher than those in the mild lesion group and the moderate lesion group,the WMR and NLR in the moderate lesion group were higher than those in the mild lesion group,25-OH-D in the severe lesion group was lower than those in the mild lesion group and the moderate lesion group,25-OH-D in the moderate lesion group was lower than that in the mild lesion group,the differences were statistically significant(P<0.05);correlation analysis showed that 25-OH-D was negatively correlated with Gensini score(r=-0.386,P<0.05),and WMR and NLR were positively correlated with Gensini score(r=0.674,0.621,P<0.05);all patients were followed up for 12-24 months,the average was(15.65±1.98)months,the patients were divided into the non-MACE group(85 cases)and MACE group(35 cases)according to whether MACE occurred in the early-onset group,the WMR and NLR in the MACE group were higher than those in the non-MACE group,and the 25-OH-D was lower than that in the non-MACE group,the differences were statistically significant(P<0.05);multifactor analysis showed that WMR and NLR were risk factors for MACE,and 25-OH-D was protective factor for MACE(P<0.05);according to receiver operating characteristic(ROC)curve analysis,the sensitivity and specificity of combined assessment of 25-OH-D,WMR and NLR were higher than those of single detection,and the value of combined assessment of MACE was higher.Conclusion:25-OH-D,WMR and NLR are significantly correlated with the degree of coronary artery disease and in-hospital MACE in female patients with early-onset coronary heart disease,which can provide an effective basis for the evaluation of the degree of coronary artery disease and in-hospital MACE in female patients with coronary heart disease.

关键词

早发冠心病/25-羟维生素D/白细胞计数与平均血小板体积比值/中性粒细胞与淋巴细胞比值

Key words

Early-onset coronary heart disease/25-hydroxyvitamin D/Ratio of white blood cell count to mean platelet volume/Neutrophil to lymphocyte ratio

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基金项目

宁夏回族自治区卫生健康系统科研课题项目(2022-NWKY-007)

出版年

2024
中外医学研究
中国医院管理杂志社

中外医学研究

影响因子：1.149
ISSN：1674-6805
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