高密度脂蛋白相关比值指数与糖尿病患者冠脉支架植入术后再狭窄发生的关联研究

doi:10.12092/j.issn.1009-2501.2026.06.008

摘要/Abstract

摘要：

目的: 本研究拟探索中性粒细胞/高密度脂蛋白比值（NHR）、淋巴细胞/高密度脂蛋白比值（LHR）、单核细胞/高密度脂蛋白比值（MHR）及血小板/高密度脂蛋白比值（PHR）与糖尿病患者冠脉支架植入后再狭窄的关联性。方法: 纳入2021年11月至2024年11月行冠状动脉支架植入术，并复查冠脉造影的糖尿病患者。根据复查造影结果分为未再狭窄组（62例）和再狭窄组（48例），单因素/多因素回归分析、剂量-反应曲线、相关性分析、ROC分析和决策曲线分析评估NHR、LHR、MHR及PHR对再狭窄发生的关联性和预测价值，并建立列线图。结果: 相较于未再狭窄组，再狭窄组患者低密度脂蛋白胆固醇、脂蛋白（a）、NHR、MHR和PHR水平显著增加（P<0.05），Logistic回归分析显示NHR、MHR、PHR与糖尿病患者冠脉支架再狭窄发生呈独立相关，且NHR、MHR、PHR水平与再狭窄发生呈正相关。LHR与再狭窄发生没有显著关联。ROC曲线显示MHR和PHR水平对糖尿病患者冠脉支架再狭窄的发生有较好的预测效能。结论: NHR、MHR、PHR水平与糖尿病患者冠脉支架再狭窄存在显著关联，是预测再狭窄发生的有效指标。

关键词: 高密度脂蛋白相关比值指数, 支架内再狭窄, 冠心病, 糖尿病

Abstract:

AIM: To explore the relationship between neutrophil/high density lipoprotein ratio (NHR), lymphocyte/high density lipoprotein ratio (LHR), monocyte/high density lipoprotein ratio (MHR) and platelet/high density lipoprotein ratio (PHR) and in-stent restenosis in diabetic patients after percutaneous coronary intervention. METHODS: From November 2021 to November 2024, 110 diabetic patients underwent percutaneous coronary intervention and re-examined coronary angiography were included. They were divided into non-restenosis group (62 cases) and restenosis group (48 cases). The correlation and predictive value of NHR, LHR, MHR and PHR for restenosis were evaluated by univariate/multivariate regression analysis, restricted cubic spline curves, correlation analysis, ROC analysis and decision curve analysis. Nomogram was established. RESULTS: Compared with the non-restenosis group, the levels of low-density lipoprotein cholesterol, lipoprotein (a), NHR, MHR and PHR in the restenosis group increased significantly (P<0.05). Logistic regression analysis showed that NHR, MHR and PHR were independently correlated with the restenosis in diabetic patients after percutaneous coronary intervention, and the levels of NHR, MHR and PHR were positively correlated with the occurrence of restenosis. There was no significant correlation between LHR and restenosis. ROC curve showed that MHR and PHR levels have a good predictive effect on the occurrence of restenosis in diabetic patients after percutaneous coronary intervention. CONCLUSION: NHR, MHR and PHR are significantly correlated with restenosis in diabetic patients after percutaneous coronary intervention, and they are effective indicators for predicting restenosis.

Key words: high density lipoprotein related ratio index, in-stent restenosis, coronary artery disease, diabetes

中图分类号:

吴瑶, 周旋, 王小燕, 汪带娣, 孙振. 高密度脂蛋白相关比值指数与糖尿病患者冠脉支架植入术后再狭窄发生的关联研究[J]. 中国临床药理学与治疗学, 2026, 31(6): 789-797.

Yao WU, Xuan ZHOU, Xiaoyan WANG, Daidi WANG, Zhen SUN. Correlation between high density lipoprotein-related ratio index and in-stent restenosis in diabetic patients after percutaneous coronary intervention[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(6): 789-797.

图/表 8

参考文献 24

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Item	No restenosis group	Restenosis group	χ²/Z/t	P
Number of cases	62	48	-	-
Male	48 (77.4%)	36 (75%)	0.09	0.77
Age	61.56±11.36	62.19±12.61	0.28	0.78
History of hypertension	40 (64.5%)	35 (72.9%)	0.90	0.35
Smoking history	16 (25.8%)	13 (27.1%)	0.02	0.88
Duration of diabetes mellitus	9 (5, 11.25)	9.5 (6.25, 14)	1.12	0.26
BMI （kg/m²）	25.34±5.14	25.52±5.52	1.15	0.25
Total cholesterol (mmol/L)	3.88±1.24	4.05±1.29	0.71	0.48
Triglycerides (mmol/L)	1.22 (0.94, 1.56)	1.29 (0.97, 1.82)	1.01	0.31
High-density lipoprotein cholesterol (mmol/L)	1.08 (0.91, 1.29)	1.08 (0.91, 1.25)	0.29	0.78
Low-density lipoprotein cholesterol (mmol/L)	2.36±0.89	2.84±1.07	2.57	0.012
Lipoprotein(a) [Lp(a)]	96.65 (50.30, 248.25)	202.35 (106.15, 344.85)	3.08	0.003
White blood cell count (×10?/L)	7.06 (5.65, 7.97)	6.54 (5.50, 7.76)	0.73	0.46
Neutrophil count (×10?/L)	4.54 (3.60, 5.19)	4.97 (3.89, 6.21)	1.88	0.06
Lymphocyte count (×10?/L)	1.69±0.61	1.86±0.58	1.42	0.16
Monocyte count (×10?/L)	0.41 (0.36, 0.52)	0.50 (0.35, 0.60)	1.66	0.10
Platelet count (×10?/L)	203 (178.25, 254)	221 (198.25, 273.5)	1.83	0.07
Glomerular filtration rate (GFR)	96.50 (87.75, 108.00)	99.00 (88.50, 111.50)	0.69	0.49
Creatinine (μmol/L)	89.10±26.50	90.79±31.03	0.18	0.76
Blood urea nitrogen (mmol/L)	7.35±1.87	7.14±1.80	0.89	0.56
Alanine aminotransferase (U/L)	22.50 (13.75, 36.63)	18.65 (12.23, 32.58)	1.35	0.18
Aspartate aminotransferase (U/L)	24.00 (18.50, 32.25)	21.11 (16.10, 29.50)	1.50	0.13
D-dimer	0.25 (0.18, 0.36)	0.27 (0.16, 0.37)	0.26	0.80
Glycated hemoglobin (HbA1c)	6.50 (6.00, 7.30)	6.55 (6.00, 7.95)	0.15	0.88
Fasting blood glucose (mmol/L)	5.69 (4.37, 7.63)	7.62 (5.30, 10.39)	2.86	0.004
Ejection fraction (%)	58 (53, 61.25)	58.50 (54.25, 62.00)	0.47	0.64
NHR	3.91 (2.88, 5.59)	4.70 (3.71, 6.03)	2.10	0.036
LHR	1.49 (1.11, 2.03)	1.60 (1.19, 2.15)	1.31	0.19
MHR	0.40 (0.29, 0.49)	0.46 (0.36, 0.56)	2.43	0.015
PHR	200.15 (165.26, 229.70)	216.68 (179.50, 256.80)	2.46	0.014

Item	No restenosis group	Restenosis group	χ²/Z/t	P
Number of cases	62	48	-	-
Male	48 (77.4%)	36 (75%)	0.09	0.77
Age	61.56±11.36	62.19±12.61	0.28	0.78
History of hypertension	40 (64.5%)	35 (72.9%)	0.90	0.35
Smoking history	16 (25.8%)	13 (27.1%)	0.02	0.88
Duration of diabetes mellitus	9 (5, 11.25)	9.5 (6.25, 14)	1.12	0.26
BMI （kg/m²）	25.34±5.14	25.52±5.52	1.15	0.25
Total cholesterol (mmol/L)	3.88±1.24	4.05±1.29	0.71	0.48
Triglycerides (mmol/L)	1.22 (0.94, 1.56)	1.29 (0.97, 1.82)	1.01	0.31
High-density lipoprotein cholesterol (mmol/L)	1.08 (0.91, 1.29)	1.08 (0.91, 1.25)	0.29	0.78
Low-density lipoprotein cholesterol (mmol/L)	2.36±0.89	2.84±1.07	2.57	0.012
Lipoprotein(a) [Lp(a)]	96.65 (50.30, 248.25)	202.35 (106.15, 344.85)	3.08	0.003
White blood cell count (×10?/L)	7.06 (5.65, 7.97)	6.54 (5.50, 7.76)	0.73	0.46
Neutrophil count (×10?/L)	4.54 (3.60, 5.19)	4.97 (3.89, 6.21)	1.88	0.06
Lymphocyte count (×10?/L)	1.69±0.61	1.86±0.58	1.42	0.16
Monocyte count (×10?/L)	0.41 (0.36, 0.52)	0.50 (0.35, 0.60)	1.66	0.10
Platelet count (×10?/L)	203 (178.25, 254)	221 (198.25, 273.5)	1.83	0.07
Glomerular filtration rate (GFR)	96.50 (87.75, 108.00)	99.00 (88.50, 111.50)	0.69	0.49
Creatinine (μmol/L)	89.10±26.50	90.79±31.03	0.18	0.76
Blood urea nitrogen (mmol/L)	7.35±1.87	7.14±1.80	0.89	0.56
Alanine aminotransferase (U/L)	22.50 (13.75, 36.63)	18.65 (12.23, 32.58)	1.35	0.18
Aspartate aminotransferase (U/L)	24.00 (18.50, 32.25)	21.11 (16.10, 29.50)	1.50	0.13
D-dimer	0.25 (0.18, 0.36)	0.27 (0.16, 0.37)	0.26	0.80
Glycated hemoglobin (HbA1c)	6.50 (6.00, 7.30)	6.55 (6.00, 7.95)	0.15	0.88
Fasting blood glucose (mmol/L)	5.69 (4.37, 7.63)	7.62 (5.30, 10.39)	2.86	0.004
Ejection fraction (%)	58 (53, 61.25)	58.50 (54.25, 62.00)	0.47	0.64
NHR	3.91 (2.88, 5.59)	4.70 (3.71, 6.03)	2.10	0.036
LHR	1.49 (1.11, 2.03)	1.60 (1.19, 2.15)	1.31	0.19
MHR	0.40 (0.29, 0.49)	0.46 (0.36, 0.56)	2.43	0.015
PHR	200.15 (165.26, 229.70)	216.68 (179.50, 256.80)	2.46	0.014

Influencing factors	OR (95% CI)	P
Low-density lipoprotein cholesterol	1.68 (1.03-2.56)	0.016
Lipoprotein(a) [Lp(a)]	1.02 (1.00-1.04)	0.012
Fasting blood glucose	1.14 (1.01-1.28)	0.03
NHR	1.25 (1.01-1.56)	0.02
LHR	1.79 (0.97-3.33)	0.06
MHR	1.33 (1.03-1.71)	0.03
PHR	1.12 (1.04-1.21)	0.003

Influencing factors	OR (95% CI)	P
Low-density lipoprotein cholesterol	1.68 (1.03-2.56)	0.016
Lipoprotein(a) [Lp(a)]	1.02 (1.00-1.04)	0.012
Fasting blood glucose	1.14 (1.01-1.28)	0.03
NHR	1.25 (1.01-1.56)	0.02
LHR	1.79 (0.97-3.33)	0.06
MHR	1.33 (1.03-1.71)	0.03
PHR	1.12 (1.04-1.21)	0.003

	Model 1		Model 2		Model 3
Influencing factors	OR (95% CI)	P	OR (95% CI)	P	OR (95% CI)	P
NHR	1.27 (1.01-1.59)	0.04	1.27 (1.01-1.60)	0.04	1.26 (0.97-1.64)	0.077
LHR	1.70 (0.90-3.22)	0.10	1.64 (0.86-3.12)	0.13	1.31 (0.67-2.56)	0.43
MHR	1.42 (1.07-1.87)	0.014	1.41 (1.07-1.87)	0.016	1.48 (1.08-2.03)	0.014
PHR	1.14 (1.05-1.24)	0.002	1.14 (1.04-1.24)	0.004	1.10 (1.01-1.2)	0.035