内科

目的探讨中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）及尿酸（UA）水平与超重/肥胖人群并发冠心病的关系。方法选取2019年3月至2020年3月于桂林市某医院心内科完成冠脉造影检查的超重或肥胖人群为研究对象，收集其人口学资料，对其进行体格检查、生化指标检测；对超重/肥胖患者发生冠心病的影响因素进行单因素分析以及多因素logistic回归分析；绘制ROC曲线，分析NLR、PLR、UA预测冠心病的价值；对NLR、PLR、UA水平与Gensini积分的关系进行Pearson相关性分析。结果共纳入超重/肥胖患者429例，其中冠心病患者275例（冠心病组），非冠心病患者164例（非冠心病组）。单因素分析结果显示，两组患者的年龄、性别、高血压病、糖尿病、高脂血症、TC水平、TG水平比较，差异均无统计学意义（P＞0.05）；冠心病组患者的NLR、PLR、UA、LDL水平显著高于非冠心病组，HDL水平显著低于非冠心病组，差异有统计学意义（P＜0.05）。多因素logistic回归分析结果显示，NLR、PLR、UA均为超重/肥胖患者发生冠心病的独立危险因素（P＜0.05）。ROC曲线分析结果显示，NLR诊断冠心病的效能最优，曲线下面积为0.636；NLR截点值为0.250时，其预测超重/肥胖人群发生冠心病的灵敏度为67.7%，特异度为87.3%。Pearson相关分析显示，NLR、PLR、UA水平与Gensini积分均呈正相关。结论NLR、PLR、UA水平与超重/肥胖患者并发冠心病有较强的关联性，定期检测可较好地指导超重/肥胖患者早期冠心病的诊断和治疗。

ObjectiveTo investigate the relationship of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), uric acid (UA) level, with coronary heart disease (CHD) in overweight or obese population. MethodsThe overweight or obese population who completed coronary angiography in the Department of Cardiology of a hospital in Guilin from March 2019 to March 2020 were selected as the research objects, and the demographic data were collected, physical examination and biochemical indexes were conducted and detected. Univariate analysis and multivariate logistic regression analysis were used to analyze the influencing factors for coronary heart disease in overweight/obese patients. ROC curve was drawn to analyze the value of NLR, PLR and UA in predicting coronary heart disease. Pearson correlation analysis was used to analyze the relationship between Gensini score and NLR, PLR, as well as UA level. ResultsA total of 429 overweight/obese patients were enrolled, among which 275 patients with CHD were enrolled in CHD group, whereas 164 patients with non-CHD were enrolled in the non-CHD group. The results of univariate analysis showed that there were no statistically significant differences in age, gender, hypertension, diabetes, hyperlipidemia, TC level and TG level between the two groups (P＞0.05). The NLR, PLR, levels of UA and LDL in the CHD group were significantly higher than those in the non-CHD group, and the level of HDL was significantly lower than that in the non-CHD group (P＜0.05). The results of multivariate logistic regression analysis showed that NLR, PLR and UA were independent risk factors for CHD in overweight/obese patients (P＜0.05). The results of ROC curve analysis interpreted that NLR had the best diagnostic efficiency of CHD, with the area under the curve of 0.636, when the cut-off value of NLR was 0.250, the sensitivity and specificity for predicting CHD were 67.7% and 87.3%, respectively. Pearson correlation analysis expressed that NLR, PLR, UA were positively correlated with Gensini score. ConclusionNLR, PLR and UA level were strongly correlation with CHD in overweight/obese patients. Regular detection can better guide the diagnosis and treatment of early CHD in overweight/obese patients.