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| The relationship between the platelet to lymphocyte ratio and the stability of coronary plaque in patients with coronary heart disease |
| SONG Bofan1,2 Nuremanguli·Abudukeremu2 GAO Yanlin1 CHENG Wei1 |
1.Ward One, Department of Cardiovascular Medicine, the Second People′s Hospital of Anhui Province, Anhui Province, Hefei 230041, China;
2.Ward Two of Coronary Heart Disease, Department of Cardiovascular Medicine, the First People′s Hospital of Kashi Region, Xinjiang Uygur Autonomous Region, Kashi 844000, China |
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Abstract Objective To study the relationship between platelet (PLT) to lymphocyte (LYM) ratio (PLR) and coronary plaque stability in patients with coronary heart disease (CHD). Methods Two hundred and ninety-two patients with CHD admitted to the Second People′s Hospital of Anhui Province (“our hospital” for short) from January 2016 to January 2019 were selected as CHD group. According to the characteristics of plaque, they were divided into vulnerable plaque group (155 cases) and stable plaque group (137 cases). One hundred and fifty volunteers who took physical examination in our hospital during the same period were selected as control group. Blood cell analysis, blood pressure, blood glucose, blood lipid, liver and kidney function between groups were measured. The risk factors of vulnerable plaque in CHD patients were analyzed by logistic regression, and the diagnostic value of each index was evaluated by ROC curve analysis. Results The body mass index (BMI), the percentage of hypertension and diabetes, C-reactive protein (CRP), serum creatinine (Scr), urea nitrogen (BUN), PLT and PLR in stable plaque group were higher than those in control group, and LYM was lower than that in control group, with statistically significant differences (P < 0.05). BMI, percentage of hypertension and diabetes, CRP, Scr, BUN, FIB and PLR in vulnerable plaque group were higher than those in stable plaque group and control group, triglycerides, LDL cholesterol, total cholesterol, alanine aminotransferase, leukocytes and PLT in vulnerable plaque group were higher than those in control group, LYM of vulnerable plaque group was lower than that of control group, with statistically significant differences (P < 0.05). Multivariate logistic regression analysis showed that PLR (OR = 3.320, 95%CI: 1.622-6.795, P = 0.001), CRP (OR = 2.380, 95%CI: 1.292-4.384, P = 0.005), FIB (OR = 1.862, 95%CI: 1.117-3.105, P = 0.017) were independent risk factors for CHD plaque instability. The sensitivity and specificity of three methods in the diagnosis of CHD was 0.916 and 0.891 respectively. Conclusion PLR is significantly increased in CHD patients, which is an independent risk factor for the stability of coronary plaque. Attention to PLR can guide clinical diagnosis and treatment.
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[1] Libby P. Inflammation in atherosclerosis[J]. Arterioscler Thromb Vasc Biol，2012，32（9）：2045-2051.
[2] Nichenametla G，Thomas VS. Evaluation of serum pregnancy associated plasma protein-A ＆ plasma D-dimer in acute coronary syndrome [J]. J Clin Diagn Res，2016，10（1）：BC01-BC03.
[3] Wirtz TH，Tillmann S，Strüβmann T，et al. A novel platelet chemokine with distinct recruitment properties [J]. Atheros-clerosis，2015，239（1）：1-10.
[4] Krenn-Pilko S，Langsenlehner U，Thurner EM，et al. The elevated preoperative platelet-to-lymphocyte ratio predicts poor prognosis in breast cancer patients [J]. Br J Cancer，2014，110（10）：2524-2530.
[5] Zhang H，Gao L，Zhang B，et al. Prognostic value of platelet to lymphocyte ratio in non-small cell lung cancer：a systematic review and meta-analysis [J]. Sci Rep，2016，6：22618.
[6] You J，Zhu GQ，Xie L，et al. Preoperative platelet to lymphocyte ratio is a valuable prognostic biomarker in patients with colorectal cancer [J]. Oncotarget，2016，7（18）：25516-25527.
[7] Ozcan Cetin EH，Cetin MS，Aras D，et al. Platelet to lymphocyte ratio as a prognostic marker of in-Hospital and longterm major adverse cardiovascular events in ST-segment elevation myocardial infarction [J]. Angiology，2016，67（4）：336-345.
[8] 葛均波，徐永健.内科学[M].8版.北京：人民卫生出版社，2013：227-255.
[9] Mintz GS，Nissen SE，Anderson WD，et al. American College of Cardiology Clinical Expert Consensus Document on Standards for Acquisition, Measurement and Reporting of Intravascular Ultrasound Studies （IVUS）. A report of the American College of Cardiology Task Force on Clinical Expert Consensus Doc [J]. J Am Coll Cardiol，2001，37（5）：1478-1492.
[10] Hansson GK，Libby P，Tabas I. Inflammation and plaque vulnerability [J]. J Intern Med，2015，278（5）：483-493.
[11] 张本娜，贾佳，刘志科，等.颈动脉不同部位斑块与冠心病的关联研究[J].第三军医大学学报，2018，40（2）：160-164.
[12] 谢阳，安冬青.中西药治疗冠状动脉粥样硬化性心脏病概况[J].实用中医内科杂志，2015，29（6）：179-182.
[13] 孙国鑫.冠心病中Kallistatin与炎症的相关性研究[D].南京：东南大学，2017.
[14] Nagasawa A，Matsuno K，Tamura S，et al. The basis examination of leukocyte-platelet aggregates with CD45 gating as a novel platelet activation marker [J]. Int J Lab Hematol，2013，35（5）：534-541.
[15] 孙亚召，孙东旭，黄淑田.血小板-淋巴细胞比值在急性冠脉综合征评估中的应用[J].中国慢性病预防与控制，2019，27（3）：231-233.
[16] Zhang WW，Liu KJ，Hu GL，et al. Preoperative platelet/lymphocyte ratio is a superior prognostic factor compared to other systemic inflammatory response markers in ovarian cancer patients [J]. Tumor Biol，2015，36（11）：1-7.
[17] 余锋，信梦雪，刘静，等.急性冠脉综合征患者Th/Tregs水平的变化及其临床意义[J].海南医学，2018，29（11）：1486-1489.
[18] 舒红军，郭靖涛，周江，等.急性冠脉综合征患者血清GDF-15 YKL-40水平及颈动脉硬化与冠状动脉病变程度的关系[J].河北医学，2019，25（6）：919-922.
[19] Zhou X，Du Y，Huang Z，et al. Prognostic value of PLR in various cancers: a meta-analysis [J]. PLoS One，2014， 9（6）：e101119.
[20] 李春光，黄宇玲，刘杰，等.纤维蛋白原及同型半胱氨酸与冠脉易损斑块的相关性[J].当代医学，2018，24（34）：6-9. |
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