孤立性冠状动脉瘤患者淋巴细胞与单核细胞比值、冠状动脉平均直径和尿酸水平与冠状动脉慢血流的相关性。
Association of the lymphocyte-to-monocyte ratio, mean diameter of coronary arteries, and uric acid level with coronary slow flow in isolated coronary artery ectasia.
机构信息
Department of Cardiology, Chinese Academy of Medical Sciences Fuwai Hospital, No. 167 North Lishi Road, Xicheng District, Beijing, 100037, China.
出版信息
BMC Cardiovasc Disord. 2021 Mar 30;21(1):156. doi: 10.1186/s12872-021-01952-4.
BACKGROUND
The pathophysiology of isolated coronary artery ectasia (CAE) with the coronary slow flow (CSF) phenomenon is still unclear. The purpose of this study was to investigate the risk factors for isolated CAE complicated with CSF.
METHODS
A total of 126 patients with isolated CAE were selected retrospectively. The patients were grouped into the no CSF (NCSF) group (n = 55) and the CSF group (n = 71) according to the corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC). Data on demographics, laboratory measurements, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), CTFC and diameters of three coronary arteries were collected.
RESULTS
The proportions of males (84.5% vs. 61.8%, p = 0.004) and patients with a smoking history (63.4% vs. 43.6%, p = 0.021) were higher in the CSF group than in the NCSF group. The neutrophil-to-lymphocyte ratio (NLR) (2.08(1.68-3.21) vs. 1.89 ± 0.58, p = 0.001), mean diameter of coronary arteries (mean D) (5.50 ± 0.85 vs. 5.18 ± 0.91, p < 0.001), and uric acid (URIC) level (370.78 ± 109.79 vs. 329.15 ± 79.71, p = 0.019) were significantly higher in the CSF group, while the lymphocyte-to-monocyte ratio (LMR) (4.81 ± 1.66 vs. 5.96 ± 1.75, p < 0.001) and albumin (ALB) level (44.13 ± 4.10 vs. 45.69 ± 4.11, p = 0.036) were lower. Multivariable logistic analysis showed that the LMR (odds ratio: 0.614, 95% CI: 0.464-0.814, p = 0.001), mean D (odds ratio: 2.643, 95% CI: 1.54-4.51, p < 0.001) and URIC level (odds ratio: 1.006, 95% CI: 1.001-1.012, p = 0.018) were independent predictors of CSF in CAE.
CONCLUSIONS
The LMR was a negative independent predictor of CSF in isolated CAE, while URIC level and mean D were positive independent predictors.
背景
孤立性冠状动脉扩张（CAE）伴冠脉慢血流（CSF）现象的病理生理学仍不清楚。本研究的目的是探讨孤立性 CAE 合并 CSF 的危险因素。
方法
回顾性选择 126 例孤立性 CAE 患者。根据校正的心肌梗死溶栓治疗（TIMI）帧数（CTFC）将患者分为无 CSF（NCSF）组（n=55）和 CSF 组（n=71）。收集患者的人口统计学、实验室测量、左心室射血分数（LVEF）、左心室舒张末期直径（LVEDd）、CTFC 以及三支冠状动脉直径等数据。
结果
与 NCSF 组相比，CSF 组男性（84.5% vs. 61.8%，p=0.004）和有吸烟史的患者比例（63.4% vs. 43.6%，p=0.021）更高。CSF 组的中性粒细胞与淋巴细胞比值（NLR）（2.08（1.68-3.21）vs. 1.89±0.58，p=0.001）、冠状动脉平均直径（mean D）（5.50±0.85 vs. 5.18±0.91，p<0.001）和尿酸（URIC）水平（370.78±109.79 vs. 329.15±79.71，p=0.019）均显著升高，而淋巴细胞与单核细胞比值（LMR）（4.81±1.66 vs. 5.96±1.75，p<0.001）和白蛋白（ALB）水平（44.13±4.10 vs. 45.69±4.11，p=0.036）均较低。多变量逻辑回归分析显示，LMR（比值比：0.614，95%置信区间：0.464-0.814，p=0.001）、mean D（比值比：2.643，95%置信区间：1.54-4.51，p<0.001）和 URIC 水平（比值比：1.006，95%置信区间：1.001-1.012，p=0.018）是 CAE 中 CSF 的独立预测因子。
结论
LMR 是孤立性 CAE 中 CSF 的负性独立预测因子，而 URIC 水平和 mean D 是 CSF 的正性独立预测因子。
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