单核细胞/高密度脂蛋白胆固醇比值对高血压患者冠状动脉钙化的预测价值

许旭光; 谢丽响; 徐通达

doi:10.3969/j.issn.2096-3882.2022.12.003

单核细胞/高密度脂蛋白胆固醇比值对高血压患者冠状动脉钙化的预测价值

Predictive value of monocyte to high density lipoprotein cholesterol ratio for coronary artery calcification in patients with hypertension. XU Xuguang 1 XIE Lixiang 2 XU Tongda 1* (BE2019639)

摘要

摘要: 目的探讨单核细胞/高密度脂蛋白胆固醇比值(monocyte/high density lipoprotein cholesterol ratio, MHR)对高血压患者冠状动脉钙化的预测价值。方法收集2018年7月至2020年12月于徐州医科大学附属医院心内科就诊的高血压患者153例，根据冠状动脉CT血管造影（coronary CT angiography，CTA）结果，分为冠状动脉非钙化组和冠状动脉钙化组，收集患者一般资料及实验室检测结果，并计算出MHR。采用 Pearson 法分析MHR与冠状动脉钙化评分(coronary artery calcification score，CACS)分值的相关性。采用ROC曲线分析MHR对高血压患者冠状动脉钙化是否存在预测价值。结果高血压患者冠状动脉非钙化组与冠状动脉钙化组在年龄、吸烟、糖尿病、白细胞数、单核细胞数、高密度脂蛋白胆固醇及MHR水平方面比较差别具有统计学意义（P<0.05）。不同钙化程度的高血压患者之间MHR与CACS分值比较差异具有统计学意义（P<0.05）；随着钙化程度的加剧，MHR水平也随之增加（P<0.05）。高血压患者MHR与CACS分值呈正相关（r=0.475,P<0.01）。ROC曲线分析显示，MHR预测冠状动脉钙化的曲线下面积（AUC）为0.684（95%CI：0.600-0.767，P<0.01），最佳临界值为0.310时，其敏感度和特异性分别为0.671和0.592。MHR预测冠状动脉重度钙化的AUC为0.828（95%CI：0.741-0.915，P<0.01），最佳临界值为0.361时，其敏感度和特异性分别为0.852和0.673。结论高血压患者MHR随着冠状动脉钙化程度的加重而升高，对高血压患者冠状动脉钙化具有一定的预测价值。

Abstract: ob＜x＞jective To investigate the predictive value of monocyte to high density lipoprotein cholesterol ratio (MHR) for coronary artery calcification in patients with hypertension.Methods From July 2018 to December 2020, a total of 153 patients with hypertension who were admitted to the Department of Cardiology, the Affiliated Hospital of Xuzhou Medical University were enrolled and divided into coronary artery non-calcification group and coronary artery calcification group according to coronary CT angiography (CTA) results.??General patient data and laboratory test results were collected and MHR was calculated.??The correlation between MHR and coronary artery calcification score (CACS) was analyzed by Pearson method.??Receiver operating characteristic (ROC) curve was used to analyze the predictive value of MHR for coronary artery calcification in patients with hypertension.?Results There were significant differences in age, smoking, diabetes, white blood cell count, monocyte count, high density lipoprotein cholesterol and MHR between non-calcified coronary artery group and calcified coronary artery group (P<0.05).??There were statistically significant differences in MHR and CACS scores among patients with different degrees of calcification (P<0.05).??With the aggravation of calcification, MHR level also increased (P<0.05).??There was a positive correlation between MHR and CACS scores in hypertensive patients (r =0.475, P<0.01).ROC curve analysis showed that the area under curve (AUC) of MHR for predicting coronary artery calcification was 0.684 (95%CI: 0.600-0.767, P<0.01). The sensitivity and specificity of MHR were 0.671 and 0.592, respectively, when the optimal cutoff value was 0.310.?The AUC of MHR for predicting severe calcification of the coronary artery was 0.828 (95%CI: 0.741-0.915, P<0.01), and the sensitivity and specificity were 0.852 and 0.673, respectively, when the optimal cutoff value was 0.361.Conclusion MHR increases with the aggravation of coronary artery calcification in patients with hypertension, which has certain predictive value for coronary artery calcification in patients with hypertension

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