人颈动脉粥样硬化斑块炎性反应与外周血血小板、淋巴细胞计数比值及玻璃样变性的相关性研究

邢本远; 戴昕妤; 丁红; 年福甲; 彭钢; 李云涛

doi:10.16766/j.cnki.issn.1674-4152.003239

人颈动脉粥样硬化斑块炎性反应与外周血血小板、淋巴细胞计数比值及玻璃样变性的相关性研究

doi: 10.16766/j.cnki.issn.1674-4152.003239

1.
南京医科大学第二附属医院全科医学科，江苏南京 210011
2.
南京医科大学第二附属医院急诊科
3.
南京医科大学第二附属医院神经外科

基金项目:

江苏省卫健委面上项目 M2022045

详细信息

通讯作者:
李云涛，E-mail：liyuntao@njmu.edu.cn

中图分类号: R543.4
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出版历程
- 收稿日期: 2023-07-07

Correlation between inflammatory response and peripheral blood platelet-lymphocyte ratio and vitelliform degeneration in human carotid atherosclerotic plaques

1.
Department of General Practice, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210011, China

摘要

摘要: 目的探讨人颈动脉粥样硬化斑块中炎性反应与外周血血小板、淋巴细胞计数比值(platelet to lymphocyte ratio，PLR)及玻璃样变性的相关性，为进一步诊治动脉粥样硬化提供新的依据。方法回顾性连续纳入2018年10月—2022年4月于南京医科大学第二附属医院神经外科接受颈动脉内膜切除术(carotid endarterectomy，CEA)治疗的颈内动脉系统粥样硬化患者39例。将切除的39个颈动脉粥样硬化斑块标本进行组织病理检测，根据斑块有无炎性反应将患者分为炎性反应组(23例)及非炎性反应组(16例)，并统计玻璃样变性例数，记录患者外周血淋巴细胞计数、血小板计数，计算PLR等血液常规检查指标，分析颈动脉粥样硬化中炎性反应与PLR及玻璃样变性的相关性。结果共纳入39例患者，其中23例颈动脉粥样硬化斑块有炎性反应，32例有玻璃样变性。2组一般资料相比，炎性反应组PLR值[135.93(124.24, 169.15)]较非炎性反应组PLR值[112.53(101.95, 123.39)]明显升高，差异有统计学意义(P=0.002)；且斑块炎性反应与玻璃样变性差异有统计学意义(P=0.035)。结论在颈动脉粥样硬化中，PLR在斑块炎性反应较重的患者中升高，且斑块内炎症反应与斑块玻璃样变性差异有统计学意义，因此检测患者血PLR值，监测斑块内炎症反应与斑块玻璃样变性两者水平变化，有助于为临床诊治和预防动脉粥样硬化提供新的依据。
- 颈动脉疾病 /
- 动脉粥样硬化 /
- 炎性反应 /
- 玻璃样变性 /
- 血小板与淋巴细胞计数比值
Abstract: Objective To investigate the correlation between inflammatory response and peripheral blood platelet-lymphocyte ratio (PLR) and vitreous degeneration in human carotid atherosclerotic plaques, and to provide a new basis for further diagnosis and treatment of atherosclerosis. Methods Thirty-nine patients with atherosclerosis of the internal carotid artery system treated by carotid endarterectomy in the Department of Neurosurgery, the Second Affiliated Hospital of Nanjing Medical University from October 2018 to April 2022 were retrospectively and consecutively included. The 39 resected carotid atherosclerotic plaque specimens were examined by histopathology, and the patients were divided into inflammatory response group and non-inflammatory response group, and vitreous degeneration and non-vitreous degeneration groups, and the patients' peripheral blood lymphocyte and platelet counts were recorded, and routine blood examination indices such as PLR were calculated to analyze the relationship between the inflammatory response in carotid atherosclerosis and PLR and the degree of vitreous degeneration. Results A total of 39 patients were included, including 23 patients with carotid atherosclerotic plaque with inflammatory response and 32 patients with hyaline degeneration. Compared with the general information for the non-inflammatory response group, the PLR value of the inflammatory response group [135.93 (124.24, 169.15)] was significantly higher than that of the non-inflammatory response group [112.53 (101.95, 123.39)], and the difference between the two groups was statistically significant (P=0.002); the difference between plaque inflammatory response and hyaline degeneration is statistically significant (P=0.035). Conclusion In carotid atherosclerosis, the PLR is increased in patients with high plaque inflammatory response, and there is a positive correlation between intraplaque inflammatory response and plaque vitreous degeneration. Therefore, measuring PLR levels in patients' blood and monitoring changes in both intraplaque inflammatory response and plaque vitreous degeneration levels may provide a new basis for clinical diagnosis, treatment and prevention of atherosclerosis.
- Carotid artery disease /
- Atherosclerosis /
- Inflammatory response /
- Hyalinisation /
- Platelet to lymphocyte ratio
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表 1 炎性反应组与非炎性反应组颈动脉粥样硬化患者基线资料比较

Table 1. Comparison of baseline data of atherosclerosis patients between the inflammatory response group and the non-inflammatory response group

组别	例数	性别(男性/女性, 例)		年龄(x±s, 岁)		高血压[例(%)]			糖尿病[例(%)]			冠心病[例(%)]
组别	例数	性别(男性/女性, 例)		年龄(x±s, 岁)		有	无		有	无		有	无
炎性反应组	23	20/3		66.61±7.60		18(78.26)	5(21.74)		10(43.48)	13(56.52)		7(30.43)	16(69.57)
非炎性反应组	16	13/3		69.00±9.08		11(68.75)	5(31.25)		9(56.25)	7(43.75)		5(31.25)	11(68.75)
统计量		0.236^a		0.892^b		0.448^a			0.616^a			0.003^a
P值		0.972		0.560		0.767			0.433			0.957

组别	例数	脑卒中[例(%)]			高脂血症[例(%)]			吸烟史[例(%)]		白细胞计数[M(P₂₅, P₇₅), ×10⁹/L]	中性粒细胞计数[M(P₂₅, P₇₅), ×10⁹/L]		淋巴细胞计数(x±s, ×10⁹/L)
组别	例数	有	无		有	无		有	无	白细胞计数[M(P₂₅, P₇₅), ×10⁹/L]	中性粒细胞计数[M(P₂₅, P₇₅), ×10⁹/L]		淋巴细胞计数(x±s, ×10⁹/L)
炎性反应组	23	13(56.52)	10(43.48)		13(56.52)	10(43.48)		17(73.91)	6(26.09)	6.75(4.92, 9.28)	4.67(2.85, 5.87)		1.37±0.42
非炎性反应组	16	12(75.00)	4(25.00)		7(43.75)	9(56.25)		7(43.75)	9(56.25)	5.54(4.14, 6.92)	3.55(2.36, 4.46)		1.55±0.32
统计量		1.400^a			0.616^a			1.113^a		-1.471^c	-1.699^c		1.392^b
P值		0.237			0.433			0.291		0.141	0.089		0.216

组别	例数	红细胞计数(x±s, ×10¹²/L)		血红蛋白(x±s, g/L)		血小板计数[M(P₂₅, P₇₅), ×10⁹/L]		PLR [M(P₂₅, P₇₅)]		白蛋白[M(P₂₅, P₇₅), g/L]		单核细胞计数[M(P₂₅, P₇₅), ×10⁹/L]
炎性反应组	23	4.20±0.51		128.00±14.29		189(161, 207)		135.93(124.24, 169.15)		39.0(35.2, 42.2)		0.52(0.35, 0.61)
非炎性反应组	16	4.34±0.71		130.00±19.10		170(151, 195)		112.53(101.95, 123.39)		39.5(36.3, 42.7)		0.38(0.29, 0.61)
统计量		0.709^b		0.429^b		-1.457^c		-3.084^c		-0.957^c		-1.215^c
P值		0.511		0.346		0.145		0.002		0.339		0.225

组别	例数	甘油三酯[M(P₂₅, P₇₅)，mmol/L]		总胆固醇(x±s, mmol/L)		低密度脂蛋白胆固醇(x±s, mmol/L)		高密度脂蛋白胆固醇(x±s, mmol/L)		载脂蛋白A1 [M(P₂₅, P₇₅), g/L]		载脂蛋白B (x±s, g/L)
炎性反应组	23	1.17(0.89, 1.46)		3.78±0.95		2.02±0.75		1.05±0.29		1.12(0.97, 1.26)		0.99±0.26
非炎性反应组	16	1.36(1.11, 1.48)		3.96±0.83		2.12±0.69		1.10±0.34		1.19(1.06, 1.31)		1.00±0.21
统计量		-1.271^c		0.608^b		0.418^b		0.510^b		-0.986^c		0.957^b
P值		0.204		0.553		0.680		0.450		0.324		0.630
注：^a为χ²值，^b为t值，^c为Z值。

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表 2 颈动脉粥样硬化斑块炎性反应与玻璃样变性之间的比较[例(%)]

Table 2. Comparison between inflammatory response and vitreous degeneration in carotid atherosclerotic plaques [cases (%)]

组别	例数	玻璃样变性	非玻璃样变性
炎性反应组	23	20(51.3)	3(7.7)
非炎性反应组	16	12(30.8)	4(10.2)
注：2组炎性反应与玻璃样变性比较，P=0.035。

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