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目的研究非ST段抬高型急性冠脉综合征(NSTE-ACS)患者全球急性冠状动脉事件注册(GRACE)危险评分、中性粒细胞/淋巴细胞比值(NLR)与冠状动脉病变程度的相关性。方法回顾性分析228例在我院住院并行冠脉造影的NSTE-ACS患者。根据GRACE评分将患者分为低危组、中危组及高危组。采用Gensini积分量化冠脉病变程度,按Gensini积分三分位间距将患者分为轻度、中度及重度病变组。分析GRACE评分、NLR与是否与不同程度的冠状动脉病变相关。结果 (1)GRACE危险分层中危组及高危组NLR及Gensini积分较低危组升高(P<0.01),3支及左主干病变发生率高于低危组(P<0.01)。冠脉重度病变组GRACE危险评分、NLR均高于轻度病变组(P<0.01)。(2)GRACE危险评分及NLR与Gensini积分呈正相关关系。GRACE危险评分联合NLR对重度冠脉病变有中等预测价值(ROC曲线下面积0.725,95%CI 0.653~0.798,P<0.01)。结论 GRACE危险评分、NLR与NSTE-ACS患者冠状动脉病变有良好相关性,可作为严重冠状动脉病变早期预测因子。
Objective To investigate the relationship between global acute coronary event registration (GRACE) risk score, neutrophil / lymphocyte ratio (NLR) and severity of coronary artery disease in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS) . Methods We retrospectively analyzed 228 patients with NSTE-ACS who underwent coronary angiography in our hospital. Patients were divided into low risk group, moderate risk group and high risk group according to GRACE score. The degree of coronary artery lesion was quantified by Gensini integral and the patients were divided into mild, moderate and severe lesion group according to Gensini integral. Analysis of GRACE score, NLR and whether with varying degrees of coronary artery disease related. Results (1) The levels of NLR and Gensini in the intermediate risk group and the high risk group were higher (P <0.01), and the incidences of the three branches and the left main trunk were higher in the risk stratified group than those in the low risk group (P <0.01). GRACE risk score and NLR in severe coronary artery disease group were higher than those in mild disease group (P <0.01). (2) There was a positive correlation between GRACE risk score and NLR and Gensini score. GRACE risk score combined with NLR had moderate predictive value for severe coronary artery disease (ROC area 0.725,95% CI 0.653-0.798, P <0.01). Conclusions There is a good correlation between GRACE risk score, NLR and coronary artery disease in patients with NSTE-ACS, which can be used as an early predictor of severe coronary artery disease.