2025 年第 10 期 第 20 卷

白细胞亚群与高密度脂蛋白胆固醇比值在冠心病风险预测及危险分层中的应用价值

The application value of white blood cell subsets to high-density lipoprotein cholesterol ratio in the risk prediction and risk stratification of coronary atherosclerotic heart disease

作者：徐双双1韩捷1陶炜伟2

英文作者：Xu Shuangshuang1 Han Jie1 Tao Weiwei2

单位：1南京中医药大学附属医院（江苏省中医院）心血管科，南京210029；2南京中医药大学附属医院（江苏省中医院）功能检查科，南京210029

英文单位：1Department of Cardiovascular Affiliated Hospital of Nanjing University of Chinese Medicine Jiangsu Province Hospital of Chinese Medicine Nanjing 210029 China; 2Department of Functional Examination Affiliated Hospital of Nanjing University of Chinese Medicine Jiangsu Province Hospital of Chinese Medicine Nanjing 210029 China

关键词：冠状动脉粥样硬化性心脏病；单核细胞与高密度脂蛋白胆固醇比值；中性粒细胞与高密度脂蛋白胆固醇比值；淋巴细胞与高密度脂蛋白胆固醇比值

英文关键词：Coronaryatheroscleroticheartdisease;Monocytetohigh-densitylipoproteincholesterolratio;Neutrophiltohigh-densitylipoproteincholesterolratio;Lymphocytetohigh-densitylipoproteincholesterolratio

• 摘要：

• 目的 探讨单核细胞与高密度脂蛋白胆固醇比值（MHR）、中性粒细胞与高密度脂蛋白胆固醇比值（NHR）和淋巴细胞与高密度脂蛋白胆固醇比值（LHR）在冠心病（冠状动脉粥样硬化性心脏病，CHD）风险预测及危险分层中的应用价值。方法 选取2022年3月至2024年6月在南京中医药大学附属医院接受冠状动脉造影检查的200例患者，根据造影结果分为CHD组（n=120）和非CHD组（n=80），并依据SYNTAX评分将CHD组进一步分为低危组（n=80）和中高危组（n=40）。收集患者临床资料，计算出MHR、NHR、LHR，分析三者与冠状动脉狭窄程度的关系。采用多因素Logistic回归分析CHD的独立危险因素，受试者工作特征（ROC）曲线评估各指标对CHD的预测价值。结果 CHD组MHR、NHR、LHR均显著高于非CHD组［（0.42±0.15）比（0.28±0.11）、（3.79±1.62）比（2.45±0.88）、（1.49±0.58）比（1.29±0.50）］，差异均有统计学意义（均P＜0.05）。Spearman相关分析结果显示，MHR、NHR、LHR与SYNTAX评分均呈显著正相关（r=0.460、0.496、0.156，均P＜0.05）。多因素Logistic回归分析结果表明，高血压病史、糖尿病史、吸烟史、MHR、NHR及低密度脂蛋白胆固醇均是CHD发生的独立危险因素（均P＜0.05）。ROC曲线结果显示，MHR、NHR及联合检测预测CHD的曲线下面积分别为0.785、0.790、0.826，敏感度分别为81.7%、75.0%、74.2%，特异度分别为68.7%、73.8%、81.2%。结论 MHR、NHR均是CHD发生的独立危险因素，且与冠状动脉狭窄程度呈显著正相关，联合检测对CHD的预测价值优于单项检测，具有重要的临床应用价值。

• Objective To investigate the application value of monocyte to high-density lipoprotein cholesterol ratio (MHR), neutrophil to high-density lipoprotein cholesterol ratio (NHR) and lymphocyte to high-density lipoprotein cholesterol ratio (LHR) in risk prediction and risk stratification of coronary atherosclerotic heart disease (CHD).Methods A total of 200 patients who underwent coronary angiography in the Affiliated Hospital of Nanjing University of Chinese Medicine from March 2022 to June 2024 were selected. According to the results of coronary angiography, the patients were divided into CHD group (120 cases) and non-CHD group (80 cases), and the CHD group was further divided into low-risk group (80 cases) and medium-high-risk group (40 cases) according to SYNTAX score. The clinical data of patients were collected, and the relationship between MHR, NHR, LHR and the degree of coronary artery stenosis was analyzed.Multivariate Logistic regression was used to analyze the independent risk factors of CHD, and the receiver operating characteristic (ROC) curve was used to evaluate the predictive value of each index for CHD. Results The MHR, NHR and LHR of the CHD group were significantly higher than those of the non-CHD group ［(0.42±0.15) vs (0.28±0.11), (3.79±1.62) vs (2.45±0.88), (1.49±0.58) vs (1.29±0.50)］(all P<0.05). Spearman correlation analysis showed that MHR, NHR and LHR were significantly positively correlated with SYNTAX score (r=0.460, 0.496, 0.156, all P<0.05). Multivariate Logistic regression analysis showed that history of hypertension, history of diabetes, history of smoking, MHR, NHR and low-density lipoprotein cholesterol were independent risk factors for CHD (all P<0.05). ROC curve results showed that the area under the curve of MHR, NHR and combined detection for predicting CHD were 0.785, 0.790 and 0.826, respectively; the sensitivity were 81.7%, 75.0% and 74.2%, and the specificity were 68.7%, 73.8% and 81.2%, respectively. Conclusion Both MHR and NHR are independent risk factors for CHD, and are significantly positively correlated with the degree of coronary artery stenosis. The predictive value of combined detection for CHD is better than that of single detection, which has important clinical application value.