血脂、胆红素、尿酸及不同炎性细胞与冠心病的相关性分析

目的探讨血脂、胆红素、尿酸及不同炎性细胞变化在冠状动脉粥样硬化性心脏病患者中的临床意义。方法选择142例经冠脉造影证实为冠状动脉粥样硬化性心脏病的患者,按造影结果分为单支病变组(58例),双支病变组(46例)和多支病变组(38例),并设60例冠脉造影正常患者为对照组,按照SYNTAX评分系统衡量冠脉造影结果。入院时测其白细胞计数、白细胞亚型计数及比例、中性粒细胞计数/淋巴细胞计数比值(NLR)及血脂、胆红素和尿酸,分析患者血脂、胆红素、尿酸及不同炎性细胞变化的临床意义及其与SYNTAX评分的相关性。结果随着冠脉病变支数增加,TG、LDL-C及UA水平升高(P<0.05),而TBiL、IBiL水平明显降低(P<0.05);白细胞计数、单核细胞计数及NLR值升高(P<0.05),而淋巴细胞计数降低(P<0.05);多元线性回归分析提示TG、HDL-C及UA与冠状动脉造影SYNTAX评分独立相关(其偏相关系数分别为0.264、-0.275、0.205,P<0.05),白细胞计数和NLR与SYNTAX评分独立相关(偏相关系数分别为0.587、0.342,P<0.05)。结论随着冠脉病变程度和范围进展,TG和UA水平升高而HDL-C降低;白细胞计数和NLR值升高,提示血脂和尿酸及不同炎性细胞与冠脉病变相关。

Correlation of blood lipids,bilirubin,uric acid and leukocyte subtypes with coronary heart disease

Objective To explore the relationship between blood lipids,bilirubin,uric acid and leukocyte subtypes and coronary heart disease.Methods 142 patients who underwent coronary angiography were allocated into three groups：one-vessel desease group（58 cases）,two-vessel desease group（46 cases）and multi-vessel desease group（38 cases）,60 patients who had normal coronary artery were chosen as control group.And the SYNTAX score was calculated,the blood lipids,bilirubin,uric acid and leukocyte subtypes were tested on admission.Results TG,LDL-C and UA increased with the coronary artery lesions（P〈0.05）while TBiL,IBiL decreased（P〈0.05）.The leukocytes,monocytes and the ratio of neutrophils and lymphocyte（NLR）increased with the coronary artery lesions（P〈0.05）while lymphocytes decreased（P〈0.05）.Multiple linear regression analysis showed that TG,HDL-C and UA had independent association with SYNTAX score（the partial correlation coefficient were 0.264,-0.275,0.205,respectively,P〈0.05）,leukocytes and NLR had indenpent association with SYNTAX score（the partial correlation coefficient were 0.587,0.342 respectively,P〈0.05）.Conclusion Serum TG,UA and blood leukocytes and NLR had some relationship with coronary actery lesions and its degree.