上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2026, Vol. 46 ›› Issue (7): 946-953.doi: 10.3969/j.issn.1674-8115.2026.07.013

• 论著 · 临床研究 • 上一篇    

新型炎症代谢标志物与冠心病SYNTAX评分的关联性分析

孜亚吾东·巴吾东1, 沙合木·阿那尔拜1, 阿斯亚·艾尔肯1, 叶尔肯别克·沙德克1, 李光娟1, 姜萌2()   

  1. 1.新疆维吾尔自治区伊犁哈萨克自治州友谊医院心血管内科，省部共建中亚高发病成因与防治国家重点实验室，伊宁 835000
    2.上海交通大学医学院附属仁济医院心内科，上海 200233
  • 收稿日期:2025-12-01 接受日期:2026-01-27 出版日期:2026-07-07 发布日期:2026-07-07
  • 通讯作者: 姜　萌，主任医师，博士；电子信箱：jiangmeng0919@163.com。
  • 基金资助:
    省部共建中亚高发病成因与防治国家重点实验室开放课题资助项目(SKL-HIDCA-2023-YY10);上海交通大学医学院“双百人”项目(20172014)

Novel inflammatory and metabolic biomarkers and their association with SYNTAX score in coronary heart disease

Ziyawudong·Bawudong 1, Shahemu·Anaerbai 1, Asiya·Aierken 1, Yeerkenbieke·Shadeke 1, LI Guangjuan1, Jiang Meng2()   

  1. 1.Department of Cardiovascular Medicine, Friendship Hospital, Ili Kazakh Autonomous Prefecture, Xinjiang Uyghur Autonomous Region; State Key Laboratory of Pathogenesis, Prevention and Treatment of High incidence Diseases in Central Asia, Yining 835000, China
    2.Department of Cardiovascular Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
  • Received:2025-12-01 Accepted:2026-01-27 Online:2026-07-07 Published:2026-07-07
  • Contact: Jiang Meng, E-mail: jiangmeng0919@163.com.
  • Supported by:
    State Key Laboratory of Pathogenesis, Prevention and Treatment of High incidence Diseases in Central Asia Fund(SKL-HIDCA-2023-YY10);“Two-hundred Talents” Program of Shanghai Jiao Tong University of Medicine(20172014)

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摘要：

目的·探讨中性粒细胞百分比与白蛋白比值（neutrophil percentage-to-albumin ratio，NPAR）、单核细胞与高密度脂蛋白比值（monocyte-to-high-density lipoprotein ratio，MHR）、纤维化指数4（fibrosis index-4，FIB-4）及脂蛋白（a）［lipoprotein （a），LP（a）］水平与冠心病患者经皮冠状动脉介入治疗与心脏外科手术协同作用（synergy between percutaneous coronary intervention with Taxus and cardiac surgery，SYNTAX）评分的相关性。方法·选取2023年1月—2025年1月在伊犁哈萨克自治州友谊医院心血管内科住院治疗并依据冠状动脉造影确诊的289例冠心病患者，按SYNTAX评分将其分为低危组（n=122）、中危组（n=86）和高危组（n=81）；收集患者基线资料与实验室检查数据，包括年龄、高血压病史、体质量指数（body mass index，BMI）、性别、糖尿病史、吸烟史、饮酒习惯，以及甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、LP（a）、肌酐及尿酸等指标。利用多因素Logistic回归分析，评估上述因素与冠心病患者SYNTAX评分的关联性。采用受试者工作特征曲线（receiver operating characteristic curve，ROC曲线），探讨NPAR、MHR、FIB-4及LP（a）水平对SYNTAX评分的预测效能。结果·中低危组、中危组、高危组间性别、年龄、BMI、高血压病史、吸烟史及血脂、肌酐、尿酸等基线资料比较，差异无统计学意义（均P>0.05）；而糖尿病患病率、高密度脂蛋白胆固醇、LP（a）及NPAR水平组间差异有统计学意义（均P<0.05）。将中危组与高危组合并为中高危组（n=167）；与低危组（n=122）比较，结果显示，中高危组糖尿病患病率、LP（a）及NPAR水平显著升高（均P<0.05）。多因素Logistic回归分析显示，糖尿病（OR=1.768，95%CI 1.024~3.051，P=0.041）、NPAR（OR=5.386，95%CI 2.216~13.089，P<0.001）及LP（a）（OR=1.002，95%CI 1.000~1.003，P=0.043）是冠状动脉高危病变的独立相关因素。ROC曲线分析显示：NPAR的曲线下面积（area under the curve，AUC）为0.641（95%CI 0.576~0.705，P<0.001），LP（a）的AUC为0.572（95%CI 0.505~0.639，P=0.038）；NPAR与LP（a）联合后AUC为0.665（95%CI 0.602~0.728，P<0.001），预测效能优于单一指标；而MHR（AUC=0.530，P=0.390）和FIB-4（AUC=0.525，P=0.478）的预测价值无统计学意义。结论·NPAR及LP（a）水平与SYNTAX评分呈正相关，可作为冠状动脉病变严重程度的参考指标。

关键词: 冠心病, SYNTAX评分, 中性粒细胞百分比与白蛋白比值, 单核细胞与高密度脂蛋白比值, 纤维化指数4, 脂蛋白（a）

Abstract:

Objective ·To investigate the correlations of the neutrophil percentage-to-albumin ratio (NPAR), monocyte-to-high-density lipoprotein ratio (MHR), fibrosis-4 index (FIB-4), and lipoprotein(a) [LP(a)] levels with the synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) score in patients with coronary heart disease. Methods ·A total of 289 patients with coronary heart disease hospitalized in the Department of Cardiovascular Medicine at Friendship Hospital, Ili Kazakh Autonomous Prefecture, from January 2023 to January 2025 and diagnosed by coronary angiography were enrolled. According to the SYNTAX score, patients were divided into a low-risk group (n=122), an intermediate-risk group (n=86), and a high-risk group (n=81). Baseline characteristics and laboratory data were collected, including age, history of hypertension, body mass index (BMI), gender, history of diabetes, smoking history, drinking habits, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, LP(a), creatinine, and uric acid. Multivariate Logistic regression analysis was performed to evaluate the associations between the above factors and the SYNTAX score. Moreover, receiver operating characteristic (ROC) curve analysis was used to assess the predictive accuracy of NPAR, MHR, FIB-4, and LP(a) for the SYNTAX score. Results ·No statistically significant differences were observed among the three groups in gender, age, BMI, history of hypertension, smoking history, blood lipids, creatinine, uric acid, or other baseline data (all P>0.05). However, the prevalence of diabetes and the levels of high-density lipoprotein cholesterol, LP(a), and NPAR differed significantly among the three groups (all P<0.05). After pooling the intermediate-risk and high-risk groups into an intermediate-high-risk group (n=167), comparison with the low-risk group (n=122) revealed a significantly higher prevalence of diabetes and elevated LP(a) and NPAR levels (all P<0.05). Multivariate Logistic regression analysis revealed that diabetes (OR=1.768, 95%CI 1.024‒3.051, P=0.041), NPAR (OR=5.386, 95%CI 2.216‒13.089, P<0.001), and LP(a) (OR=1.002, 95%CI 1.000‒1.003, P=0.043) were independent factors associated with high-risk coronary artery lesions. ROC curve analysis showed that the area under the curve (AUC) of NPAR was 0.641 (95%CI 0.576‒0.705, P<0.001), and that of LP(a) was 0.572 (95%CI 0.505‒0.639, P=0.038). The combined AUC of NPAR and LP(a) was 0.665 (95%CI 0.602‒0.728, P<0.001), which demonstrated superior predictive efficacy compared with either marker alone, whereas MHR (AUC=0.530, P=0.390) and FIB-4 (AUC=0.525, P=0.478) showed no statistically significant predictive value. Conclusion ·Both NPAR and LP(a) levels were positively associated with the SYNTAX score, suggesting their potential utility as reference markers for assessing the severity of coronary artery disease.

Key words: coronary heart disease, SYNTAX score, neutrophil percentage-to-albumin ratio, monocyte-to-high-density lipoprotein ratio, fibrosis index-4, lipoprotein (a)

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