外周血ELR、AST/ALT比值与急性冠脉综合征患者冠状动脉病变程度及PCI术后冠状动脉慢血流或无复流的关系OA
Association of ELR and AST/ALT ratio in peripheral blood with the degree of coronary artery lesion and coronary slow flow or no reflow after PCI in patients with acute coronary syndrome
目的 探讨外周血嗜酸性粒细胞计数/淋巴细胞计数比值(ELR)、天冬氨酸转氨酶(AST)/丙氨酸转氨酶(ALT)比值与急性冠脉综合征(ACS)患者冠状动脉病变(CAL)程度及经皮冠状动脉介入治疗(PCI)术后冠状动脉出现血流缓慢(慢血流,CSF)或供血中断、无血流信号(无复流,CNF)的关系.方法 选择2022年5月至2024年5月该院收治的126例ACS患者作为ACS组,另选取同期在该院体检的130例健康体检者作为对照组.根据Gensini评分将ACS患者分为轻度组、中度组、重度组.根据血管造影评价将ACS患者分为CSF/CNF组和血流正常组.通过电子病历系统收集ACS患者临床资料.采用Spearman相关分析ACS患者外周血ELR、AST/ALT比值与CAL程度的相关性.采用多因素Logistic回归分析ACS患者发生CSF或CNF的影响因素.绘制受试者工作特征(ROC)曲线分析ELR、AST/ALT比值单独及联合对ACS患者发生CSF或CNF的预测价值.结果 ACS组外周血ELR高于对照组,AST/ALT比值低于对照组,差异均有统计学意义(P<0.05).轻度组58例、中度组48例、重度组20例.轻度组ELR低于中、重度组,AST/ALT比值高于中、重度组,且重度组ELR高于中度组,AST/ALT比值低于中度组,差异均有统计学意义(P<0.05).Spearman相关分析结果显示,ACS患者外周血ELR与CAL程度呈正相关(r=0.465,P<0.001),AST/ALT比值与CAL程度呈负相关(r=—0.509,P<0.001).血流正常组82例,CSF/CNF组44例.CSF/CNF组外周血ELR高于血流正常组,AST/ALT比值、血红蛋白水平均低于血流正常组,差异均有统计学意义(P<0.05).多因素Logistic回归分析结果显示,ELR升高是ACS患者发生CSF或CNF的危险因素(P<0.05),AST/ALT比值升高是ACS患者发生CSF或CNF的保护因素(P<0.05).ROC曲线分析结果显示,ELR、AST/ALT比值单独及联合预测 ACS患者发生CSF或CNF的曲线下面积(AUC)分别为0.817、0.801、0.919,二者联合预测ACS患者发生CSF或CNF的AUC大于ELR、AST/ALT比值单独预测的AUC(Z=3.379、3.054,P=0.001、0.002).结论 ACS患者外周血ELR升高,AST/ALT比值降低,二者的变化与患者CAL程度有关,且对患者PCI术后发生CSF或CNF具有一定的预测价值.
Objective To investigate the relationship between peripheral blood eosinophil/lymphocyte count ratio(ELR),aspartate aminotransferase(AST)/alanine aminotransferase(ALT)ratio and the degree of coronary artery lesion(CAL)in patients with acute coronary syndrome(ACS)and coronary slow blood flow(slow flow,CSF),interruption of blood supply,and no blood flow signal(no reflow,CNF)after percuta-neous coronary intervention(PCI).Methods A total of 126 ACS patients admitted to the hospital from May 2022 to May 2024 were selected as the ACS group,and 130 healthy people who underwent physical examina-tion in the hospital during the same period were selected as the control group.ACS patients were divided into mild group,moderate group and severe group according to Gensini score.ACS patients were divided into CSF/CNF group and normal blood flow group according to angiographic evaluation.The clinical data of ACS pa-tients were collected through the electronic medical record system.Spearman correlation analysis was used to analyze the correlation between ELR,AST/ALT ratio and the degree of CAL in ACS patients.Multivariate Logistic regression was used to analyze the influencing factors of CSF or CNF in ACS patients.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of ELR and AST/ALT ratio alone or in combination for CSF or CNF in ACS patients.Results The ACS group had a significantly higher ELR peripheral blood level and a significantly lower AST/ALT ratio than the control group(P<0.05).There were 58 cases in mild group,48 cases in moderate group and 20 cases in severe group.The mild group had a significantly lower ELR and a significantly higher AST/ALT ratio than the moderate and severe groups,and the severe group had a significantly higher ELR and a significantly lower AST/ALT ratio than the moderate group(P<0.05).Spearman correlation analysis showed that peripheral blood ELR was positively correlated with CAL(r=0.465,P<0.001),and AST/ALT ratio was negatively correlated with CAL(r=-0.509,P<0.001).There were 82 cases in the normal blood flow group and 44 cases in the CSF/CNF group.The ELR in CSF/CNF group was higher than that in normal blood flow group,and the AST/ALT ratio and hemoglobin level in CSF/CNF group were lower than those in normal blood flow group,and the differ-ences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that the in-crease of ELR was a risk factor for CSF or CNF in ACS patients(P<0.05),and the increase of AST/ALT ratio was a protective factor for CSF or CNF in ACS patients(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of ELR,AST/ALT ratio alone and in combination for predicting CSF or CNF in ACS patients was 0.817,0.801 and 0.919 respectively.The AUC of the combined prediction of CSF or CNF in ACS patients was greater than that of ELR or AST/ALT ratio alone(Z=3.379,3.054,P=0.001,0.002).Conclusion ELR is in-creased and AST/ALT ratio is decreased in ACS patients.The changes of ELR and AST/ALT ratio are related to the degree of CAL,and have certain predictive value for CSF or CNF after PCI in ACS patients.
王皓;王娜;张帆;石小平
河北省秦皇岛市第二医院 心血管内科,河北 秦皇岛 066600河北省秦皇岛市第二医院 心血管内科,河北 秦皇岛 066600河北省秦皇岛市第二医院 介入医学科,河北 秦皇岛 066600河北省秦皇岛市第二医院 康复医学科,河北 秦皇岛 066600
医药卫生
急性冠脉综合征冠状动脉病变慢血流无复流嗜酸性粒细胞计数/淋巴细胞计数比值天冬氨酸转氨酶丙氨酸转氨酶
acute coronary syndromecoronary artery lesionslow flowno refloweosinophil count/lymphocyte count ratioaspartate aminotransferasealanine aminotransferase
《检验医学与临床》 2026 (5)
615-620,627,7
河北省秦皇岛市科学技术研究与发展计划项目(202301A139).
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