血小板分布寬度、中性粒細胞與淋巴細胞比值、糖化血紅蛋白與冠狀動脈病變程度的關(guān)系
發(fā)布時間：2018-08-01 08:34
【摘要】：背景冠心病(coronary heart disease,CHD)患者存在不同程度的冠脈血管病變,冠心病的危險因素影響著冠脈病變程度。這些年來有關(guān)于冠心病的危險因素[1]方面的相關(guān)性研究逐年增多且檢測越發(fā)準確。血小板分布寬度(Platelet distribution width,PDW)、中性粒細胞與淋巴細胞比值(the ratio of neutrophils and lymphocytes,NLR)、糖化血紅蛋白(Glycated hemoglobin,HbA1c)均被認為是冠心病的危險因素,它們均可獨立進行檢測,且逐漸成為這幾年來的熱門話題,其對早期預(yù)測CHD及評估冠脈病變程度的有著一定的指導(dǎo)意義,但是三者之間的相關(guān)性、與冠心病的關(guān)系及對冠脈病變程度評估的準確性及特異性是我們需要進一步研究和探討的。目的探討血小板分布寬度、中性粒細胞與淋巴細胞比值、糖化血紅蛋白對冠脈血管病變程度的影響、對其進行檢測的意義及臨床應(yīng)用價值。方法觀察對象為2015年03月至2015年12月經(jīng)新鄉(xiāng)醫(yī)學(xué)院第一附屬醫(yī)院心內(nèi)二科收治的經(jīng)心電圖、心肌壞死標志物、冠狀動脈造影術(shù)檢查并結(jié)合臨床表現(xiàn)確診的CHD患者108例,男79例,女29例,年齡31~76歲,平均(56.67±8.76)歲;血總膽固醇(total cholesterol,TC)為(4.01±1.03)mmol·L-1,三酰甘油(triacylglycerol,TG)為(1.74±1.73)mmol·L-1,低密度脂蛋白(low density lipoprotein,LDL)為(2.35±0.90)mmol·L-1,脂蛋白a(lipoprotein a,LPa)為(0.19±0.22)mmol·L-1;其中穩(wěn)定型心絞痛(stable angina pectoris,SAP)組32例,不穩(wěn)定型心絞痛(unstable angima pectoris,UAP)組38例,急性心肌梗死(acute myocardial infarction,AMI)組38例。另選同期體檢健康者112例為對照組,其中男78例,女44例,年齡42~69歲,平均(54.83±7.24)歲,TC為(3.81±0.99)mmol·L-1,TG為(1.55±0.70)mmol·L-1,LDL為(2.38±0.89)mmol·L-1,LPa為(0.18±0.20)mmol·L-1。所有觀察對象均排除急慢性炎癥性疾病、自身免疫性疾病、結(jié)締組織病、代謝性疾病(糖尿病除外)、惡性腫瘤、嚴重肝腎疾病、血液病及近期服用過可影響血PDW、中性粒細胞計數(shù)、淋巴細胞計數(shù)和HbA1c藥物的患者。正常對照組受試者于體檢當日、CHD患者均于入院次日清晨空腹抽取肘靜脈血4 mL,并測定血小板分布寬度、糖化血紅蛋白及白細胞分類計數(shù),并計算NLR。結(jié)果CHD組患者與對照組受試者年齡、性別及血脂水平比較差異無統(tǒng)計學(xué)意義(P0.05),具有可比性。CHD組患者的血PDW和NLR、HbA1c水平均顯著高于對照組,差異有統(tǒng)計學(xué)意義(P0.05)。SAP組、UAP組、AMI組患者的血PDW、NLR、Hb A1c水平與對照組受試者比較均顯著增高,差異有統(tǒng)計學(xué)意義(P0.05)。SAP組、UAP組、AMI組患者的血PDW、NLR、HbA1c水平隨著冠狀動脈狹窄程度的增加而有升高趨勢,但UAP組患者的血PDW、NLR、HbA1c水平與SAP組比較差異無統(tǒng)計學(xué)意義(P0.05),AMI組患者的血PDW、NLR、HbA1c水平較SAP組和UAP組患者均顯著增高,差異有統(tǒng)計學(xué)意義(P0.05)。SAP組、UAP組、AMI組患者的PDW、HBA1c呈顯著正相關(guān)(r=0.34、0.34、0.22,P0.05);而SAP組、UAP組、AMI組患者的NLR、PDW之間無顯著相關(guān)性(r=-0.21、-0.0013、-0.24,P0.05);SAP組、UAP組、AMI組患者的NLR、HBA1c之間無顯著相關(guān)性(r=0.16、0.04、0.16,P0.05)。結(jié)論1.PDW、NLR、HbA1c水平與冠脈狹窄程度相關(guān),可用來作為評價冠脈病變程度的指標。2.PDW、NLR、HbA1c的聯(lián)合檢測可能預(yù)測急性冠脈事件的發(fā)生。
[Abstract]:Background coronary artery disease (coronary heart disease, CHD) patients have varying degrees of coronary vascular lesions. The risk factors of coronary heart disease affect the degree of coronary artery disease. These years, the correlation of risk factors for coronary heart disease in [1] has been increased year by year and more accurate. Platelet distribution width (Platelet distribution width, PD) W), the ratio of neutrophils to lymphocytes (the ratio of neutrophils and lymphocytes, NLR), glycosylated hemoglobin (Glycated hemoglobin, HbA1c) are considered as a risk factor for coronary heart disease. They can be detected independently and gradually become a hot topic for these years. It has been used to predict the CHD and assess the degree of coronary lesions in the early stages. The relationship between the three, the relationship with the coronary heart disease and the accuracy and specificity of the assessment of the degree of coronary artery disease, we need further study and discussion. Objective to explore the effect of platelet distribution, neutrophils and lymphocyte ratio, and glycosylated hemoglobin on the degree of coronary vascular disease. The purpose of this study was to evaluate the significance and value of clinical application. Methods the subjects were 108 cases of CHD patients in two families of First Affiliated Hospital of Xinxiang Medical College from 03 months to 12 menstruation from 2015 to 2015, which were treated with electrocardiogram, myocardial necrosis markers, coronary angiography and combined with clinical manifestations in 108 cases, 79 men, 29 women, age, and flat age. The total cholesterol (total cholesterol, TC) was (4.01 + 1.03) mmol. L-1, three acyl glycerol (triacylglycerol, TG) was (1.74 + 1.73) mmol. L-1, low density lipoprotein (low density lipoprotein) was (2.35 + 0.90), and lipoprotein was (0.19 + 0.22). Gina pectoris, SAP) group 32 cases, 38 cases of unstable angina pectoris (unstable angima pectoris, UAP) group, 38 cases of acute myocardial infarction (acute myocardial infarction, AMI) group. 112 cases of healthy persons in the same period were selected as the control group, including 78 males and 44 women, age 42~69 years, average (54.83 + 7.24) years old, 3.81 + 0.99 (1.55 + 0.70). Mmol. L-1, LDL was (2.38 + 0.89) mmol. L-1, LPa was (0.18 + 0.20) mmol. L-1. all the observation subjects excluded acute and chronic inflammatory disease, autoimmune disease, connective tissue disease, metabolic disease (except diabetes), malignant tumor, severe liver and kidney disease, blood disease and recent use can affect blood PDW, neutrophils count, lymphocyte The patients in the normal control group were tested on the day of physical examination. The patients in the normal control group took 4 mL of the elbow vein blood on the early morning of the hospital on the morning of the hospital, and measured the distribution of blood platelets, glycosylated hemoglobin and the count of white blood cells, and calculated the age of the subjects in the group CHD of the CHD group and the control group, and compared the sex and blood lipid levels of the patients in the CHD group of the group CHD. There was no statistical significance (P0.05), and the blood PDW and NLR in the comparability group.CHD were significantly higher than that of the control group. The difference was statistically significant (P0.05).SAP group, UAP group, AMI group of patients with PDW, NLR, and Hb subjects were all significantly higher than those in the control group, the difference was statistically significant. The level of W, NLR, and HbA1c increased with the increase of the degree of coronary stenosis, but there was no significant difference in the level of PDW, NLR and HbA1c in the UAP group with SAP (P0.05). The level of PDW, NLR, and HbA1c in the AMI group were significantly higher than those in the group and the group. PDW, HBA1c showed significant positive correlation (r=0.34,0.34,0.22, P0.05), but there was no significant correlation between NLR and PDW in group SAP, UAP group and AMI group (r=-0.21, -0.0013, -0.24). Combined detection of.2.PDW, NLR and HbA1c as a marker for evaluating the severity of coronary artery lesions may predict the occurrence of acute coronary events.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541.4
本文編號：2156995
[Abstract]:Background coronary artery disease (coronary heart disease, CHD) patients have varying degrees of coronary vascular lesions. The risk factors of coronary heart disease affect the degree of coronary artery disease. These years, the correlation of risk factors for coronary heart disease in [1] has been increased year by year and more accurate. Platelet distribution width (Platelet distribution width, PD) W), the ratio of neutrophils to lymphocytes (the ratio of neutrophils and lymphocytes, NLR), glycosylated hemoglobin (Glycated hemoglobin, HbA1c) are considered as a risk factor for coronary heart disease. They can be detected independently and gradually become a hot topic for these years. It has been used to predict the CHD and assess the degree of coronary lesions in the early stages. The relationship between the three, the relationship with the coronary heart disease and the accuracy and specificity of the assessment of the degree of coronary artery disease, we need further study and discussion. Objective to explore the effect of platelet distribution, neutrophils and lymphocyte ratio, and glycosylated hemoglobin on the degree of coronary vascular disease. The purpose of this study was to evaluate the significance and value of clinical application. Methods the subjects were 108 cases of CHD patients in two families of First Affiliated Hospital of Xinxiang Medical College from 03 months to 12 menstruation from 2015 to 2015, which were treated with electrocardiogram, myocardial necrosis markers, coronary angiography and combined with clinical manifestations in 108 cases, 79 men, 29 women, age, and flat age. The total cholesterol (total cholesterol, TC) was (4.01 + 1.03) mmol. L-1, three acyl glycerol (triacylglycerol, TG) was (1.74 + 1.73) mmol. L-1, low density lipoprotein (low density lipoprotein) was (2.35 + 0.90), and lipoprotein was (0.19 + 0.22). Gina pectoris, SAP) group 32 cases, 38 cases of unstable angina pectoris (unstable angima pectoris, UAP) group, 38 cases of acute myocardial infarction (acute myocardial infarction, AMI) group. 112 cases of healthy persons in the same period were selected as the control group, including 78 males and 44 women, age 42~69 years, average (54.83 + 7.24) years old, 3.81 + 0.99 (1.55 + 0.70). Mmol. L-1, LDL was (2.38 + 0.89) mmol. L-1, LPa was (0.18 + 0.20) mmol. L-1. all the observation subjects excluded acute and chronic inflammatory disease, autoimmune disease, connective tissue disease, metabolic disease (except diabetes), malignant tumor, severe liver and kidney disease, blood disease and recent use can affect blood PDW, neutrophils count, lymphocyte The patients in the normal control group were tested on the day of physical examination. The patients in the normal control group took 4 mL of the elbow vein blood on the early morning of the hospital on the morning of the hospital, and measured the distribution of blood platelets, glycosylated hemoglobin and the count of white blood cells, and calculated the age of the subjects in the group CHD of the CHD group and the control group, and compared the sex and blood lipid levels of the patients in the CHD group of the group CHD. There was no statistical significance (P0.05), and the blood PDW and NLR in the comparability group.CHD were significantly higher than that of the control group. The difference was statistically significant (P0.05).SAP group, UAP group, AMI group of patients with PDW, NLR, and Hb subjects were all significantly higher than those in the control group, the difference was statistically significant. The level of W, NLR, and HbA1c increased with the increase of the degree of coronary stenosis, but there was no significant difference in the level of PDW, NLR and HbA1c in the UAP group with SAP (P0.05). The level of PDW, NLR, and HbA1c in the AMI group were significantly higher than those in the group and the group. PDW, HBA1c showed significant positive correlation (r=0.34,0.34,0.22, P0.05), but there was no significant correlation between NLR and PDW in group SAP, UAP group and AMI group (r=-0.21, -0.0013, -0.24). Combined detection of.2.PDW, NLR and HbA1c as a marker for evaluating the severity of coronary artery lesions may predict the occurrence of acute coronary events.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541.4
【參考文獻】
相關(guān)期刊論文 前10條
1 楊利娟;王筱梅;;中性粒細胞/淋巴細胞比值與心血管疾病的相關(guān)性[J];心血管康復(fù)醫(yī)學(xué)雜志;2016年06期
2 張清;盧輝和;;血小板分布寬度與急性冠狀動脈綜合征的相關(guān)性[J];中國臨床研究;2016年12期
3 許麗嬌;黃東平;汪云霞;;紅細胞分布寬度及血小板參數(shù)在急性心肌梗死診斷中的應(yīng)用研究[J];臨床醫(yī)學(xué)工程;2016年11期
4 孟令詩;;冠心病患者糖化血紅蛋白水平與冠脈病變的相關(guān)性研究[J];心血管病防治知識(學(xué)術(shù)版);2016年04期
5 李慧新;李凌;;2型糖尿病合并冠心病患者糖化血紅蛋白水平與冠狀動脈病變程度的相關(guān)性研究[J];齊齊哈爾醫(yī)學(xué)院學(xué)報;2016年05期
6 閆雅芳;王智培;趙志杰;;HbA1c對冠心病合并2型糖尿病患者冠脈病變的影響[J];臨床和實驗醫(yī)學(xué)雜志;2016年03期
7 劉年安;李新;錢江;趙闖;羅英飾;劉錫燕;陳龍;;急性心肌梗死患者冠脈病變程度與外周血炎癥介質(zhì)的關(guān)系研究[J];貴州醫(yī)藥;2016年01期
8 馬海梅;戴學(xué)慶;涂秀;;血小板異常評估CHD嚴重程度的臨床意義[J];國際檢驗醫(yī)學(xué)雜志;2016年01期
9 張曉峰;;糖化血紅蛋白測定在非糖尿病冠心病中的意義[J];中國衛(wèi)生標準管理;2015年25期
10 楊寧;趙翠;付莉;陳少伯;姜鐵民;;血小板功能檢測指導(dǎo)冠心病合并2型糖尿病擇期冠脈介入治療患者抗血小板治療的研究[J];中國慢性病預(yù)防與控制;2015年08期
相關(guān)碩士學(xué)位論文 前2條
1 谷海榮;急性心肌梗死患者血常規(guī)與冠脈病變嚴重程度的關(guān)系[D];首都醫(yī)科大學(xué);2016年
2 胡芬;健康青年人脂肪餐后血脂及血小板參數(shù)變化的研究[D];南昌大學(xué);2014年
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