单核细胞/淋巴细胞比率和单核细胞/高密度脂蛋白比率作为ACS死亡率预测因子的分析

Nanda Amelia, T. Esa
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引用次数: 0

摘要

炎症过程在急性冠脉综合征(ACS)的预后和发展中起重要作用。与ACS死亡率相关的炎症参数是单核细胞/淋巴细胞比率(MLR)和单核细胞/高密度脂蛋白比率(MHR)。本研究旨在分析基于GRACE评分的MLR和MHR作为ACS死亡率的预测因子。2019年1月至2020年12月期间,Wahidin Sudirohusodo Makassar医生对ACS患者进行横断面回顾性研究。根据GRACE评分将急性冠状动脉综合征患者分为低、中、高风险。入院时测定单核细胞/淋巴细胞比值和MHR。采用Kolmogorov-Smirnov检验、Kruskal-Wallis检验、Spearman相关检验和受试者工作特征(Receiver Operating characteristic, ROC)统计检验。以p值< 0.05为差异有统计学意义。样本包括422名ACS患者,70名低危患者,156名中危患者和196名高危患者。年龄在30-88岁之间。平均MLR为0.50±0.37,MHR为0.19±0.15。平均MLR在高危组最高(0.58),在低危组最低(0.37)(p<0.001);MHR差异不显著。单核细胞/淋巴细胞比值与GRACE评分呈正相关(p < 0.001),而MHR与GRACE评分无相关(p 0.310)。从MLR ROC曲线上看,cut-off为0.35 (AUC为0.673;95% ci 0.695-0.742)。由于持续的炎症过程,高危患者的MLR值升高。MHR值与死亡率无正相关。单核细胞/淋巴细胞比值对死亡率有预测价值,临界值为0.35,而MHR的作用还有待进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of Monocyte/Lymphocyte Ratio and Monocyte/HDL Ratio as A Predictor of Mortality in ACS
Inflammatory process plays a role in the prognosis and development of Acute Coronary Syndrome (ACS). Inflammation parameters associated with ACS mortality are Monocyte/Lymphocyte ratio (MLR) and Monocyte/High Density Lipoprotein ratio (MHR). This study aimed to analyze MLR and MHR as predictors of ACS mortality based on the GRACE score. A cross-sectional retrospective study on ACS patients at Dr. Wahidin Sudirohusodo Makassar for the period January 2019-December 2020. Acute coronary syndrome patients were grouped into low, medium and high risk based on the GRACE score. Monocyte/lymphocyte ratio and MHR were measured on admission. The Kolmogorov-Smirnov test, Kruskal-Wallis test, Spearman's correlation test and Receiver Operating Characteristics (ROC) statistical tests were used. The statistical test results were significant if the p-value < 0.05. The sample consisted of 422 ACS patients, 70 low risk patients, 156 medium risk and 196 high risk patients. Age range 30–88 years. The mean MLR 0.50±0.37 and MHR 0.19±0.15. The mean MLR was the highest significant at high risk (0.58) and the lowest at low risk (0.37) (p<0.001); while MHR was not significant. Monocyte/lymphocyte ratio was positively correlated with GRACE score (p < 0.001), while MHR was not correlated (p 0.310). From the MLR ROC curve, the cut-off was 0.35 (AUC 0.673; 95% CI 0.695-0.742). MLR values increase in high-risk patients due to the ongoing inflammatory process. The MHR value did not show a positive correlation with mortality. Monocyte/lymphocyte ratio had a predictive value on mortality with a cut-off of 0.35 while the role of MHR still requires further research.
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