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目的探讨血小板/淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)与冠状动脉完全闭塞(chronic total occlusion,CTO)患者冠状动脉侧支循环(coronary collateral circulation,CCC)形成的关系。方法选取经造影确定主要冠状动脉至少1支存在CTO病变的患者137例,根据Rentrop分级标准对患者的CCC情况进行分级,进一步分为CCC形成不良组(Rentrop 0~Ⅰ级,n=57)和CCC形成良好组(RentropⅡ~Ⅲ级,n=80)。根据患者的血常规结果计算PLR值。结果两组患者的PLR分别为163±86和108±36,侧支形成不良组的PLR显著高于侧支形成良好组(P<0.01)。多因素Logistic回归分析表明,PLR是影响CCC形成的独立相关因素(OR:1.02,95%CI:1.008~1.032;P<0.01)。经ROC曲线获得的PLR预测CCC形成不良的曲线下面积为0.75(95%CI:0.67~0.84),与超敏C反应蛋白(hs-CRP)相当;当PLR截点取140.876时,其诊断效率最高,敏感度为61%,特异度为82%。结论在CTO患者中,PLR和CCC的形成相关,高PLR水平是预测CCC形成不良的独立相关因素,其预测价值与hs-CRP相当。
Objective To investigate the relationship between the platelet-to-lymphocyte ratio (PLR) and the formation of coronary collateral circulation (CCC) in patients with coronary artery total occlusion (CTO). Methods One hundred and fourty-seven patients with at least one CTO lesion confirmed by contrast-enhanced coronary angiography were enrolled in this study. The patients’ CCC were graded according to the Rentrop classification criteria and further divided into three groups: Rentrop 0 ~ Ⅰ grade (n = 57) CCC formed a good group (Rentrop Ⅱ ~ Ⅲ grade, n = 80). PLR values were calculated based on the patient’s blood routine results. Results The PLR of the two groups were 163 ± 86 and 108 ± 36, respectively. The PLR in the poor collateral formation group was significantly higher than that in the collateral group (P <0.01). Multivariate Logistic regression analysis showed that PLR was an independent factor influencing CCC formation (OR: 1.02, 95% CI: 1.008-1.032; P <0.01). The area under the curve of PLR predicted by ROC curve was 0.75 (95% CI: 0.67-0.84), which was equivalent to hs-CRP. When the PLR cut-off point was 140.876, the diagnostic efficiency Highest, with a sensitivity of 61% and a specificity of 82%. Conclusion In patients with CTO, PLR is associated with the formation of CCC. High PLR level is an independent predictor of poor CCC formation, and its predictive value is comparable to that of hs-CRP.