中性粒细胞-淋巴细胞比值与冠脉病变严重程度相关性分析

目的：探讨外周血中性粒细胞与淋巴细胞的比值（ NLR）和冠状动脉病变的相关性。方法：选择2013年2月至2013年8月在广州医科大学附属第二医院行冠状动脉造影术的160例患者作为研究对象。根据Gensini评分将患者分成对照组24例、轻度狭窄组60例、中度狭窄组35例、重度狭窄组41例。采用Pearson相关性分析和多元线性逐步回归分析不同狭窄程度与NLR水平的关联。以受试者工作特性（ ROC）曲线分析NLR预测冠脉病变程度的最佳切点及诊断价值。结果：与对照组相比，各狭窄组NLR水平呈升高趋势，其中重度狭窄组较对照组增加（P＜0.01）。 NLR与白细胞计数（r＝0.635）、肌钙蛋白I（r＝0.535）、Gensini积分（ r＝0.211）明显相关（均P＜0.01）。肌钙蛋白I是NLR的影响因素之一（β＝0.367， t＝4.409， P＜0.01）。 ROC曲线分析证实NLR诊断冠脉重度狭窄的最佳切点是3.966，特异性74.58％，敏感性60％，曲线下面积与肌钙蛋白I相比，差异无统计学意义（ P＞0.05）。结论：NLR水平与冠脉病变严重程度明显相关，可作为早期预测因子，为临床胸痛患者及时分层治疗提供有效帮助。

Correlation between neutrophil-to-lymphocyte ratio and severity of coronary artery disease

Objective：To investigate the correlation between neutrophil-to-lymphocyte ratio （ NLR ） in peripheral blood and severity of coronary artery disease. Methods：Patients （ n=160） who underwent coronary angiography between February 2013 and August 2013 were included as the subjects in the study. All patients were divided into the control group （n=24）, mild stenosis group （n=60）, moderate stenosis group （n=35）, and severe stenosis group （ n=41） . Pearson’ s correlation analysis and multiple linear stepwise regression were used to examine the relationship between severity of coronary artery stenosis and NLR. NLR was analyzed by receiver operator characteristic （ROC） curve for its optimal cut-off point in severity prediction and diagnostic value for coronary artery lesions. Results：Compared with the control group, the NLR level showed a rising trend in each stenosis group and was significantly increased in the severe stenosis group （ P〈0. 01 ） . The NLR levels were significantly correlated with white blood cell count （r=0.635）, troponin I （r=0.535）, and Gensini score （r=0. 211） （all P〈0.01）. Troponin I was one of influential factors of NLR （β=0.367, t=4.409, P〈0.01）. The ROC curve analysis confirmed that the optimal cut-off point, specificity and sensitivity in diagnosing severe＆amp;nbsp;coronary artery stenosis by NLR were 3.966, 74.58% and 60%, respectively. There was no statistical difference in the area under curve between NLR and troponin I （ P〉0.05） . Conclusion：NLR level is significantly correlated with the severity of coronary artery lesions, and thus can be used as an early predictor to provide effective help for timely stratification treatment in patients with chest pain.