关键词: 心血管疾病, 高血压, 白细胞, 淋巴细胞, 预测, 回归分析, ROC曲线

Abstract: Background　Framingham risk score is a widely used method for predicting the 10-year risk of cardiovascular disease in high risk group.Neutrophil to lymphocyte ratio（NLR）is a newly suggested inflammatory marker associated with atherosclerosis.However，the correlation between NLR and Framingham risk score，and the predictive value of NLR for high-risk cardiovascular disease are still unclear.Objective　To explore the association of NLR with Framingham risk score，and its predictive value for high-risk cardiovascular disease.Methods　Participants were recruited from Henan Provincial People's Hospital from May 2017 to May 2018，including 168 outpatients and inpatients with essential hypertension from Cardiovascular Department〔observation group consisting of low-risk subgroup（n=66），intermediate-risk subgroup（n=53），and high-risk subgroup（n=49）stratified by Framingham risk score〕，and 55 physical examinees without hypertension from Physical Examination Department（control group）．Comparisons of clinical data were made between the control group and cardiovascular risk subgroups.Influencing factors for Framingham risk score were analyzed with the multivariate ordinal regression model.The value of NLR for predicting cardiovascular risk in high-risk population of cardiovascular disease was estimated by ROC curve analysis.Results　Sex ratio，mean age，systolic blood pressure，diastolic blood pressure，prevalence of diabetes，rates of use of drugs（statins，beta blockers，calcium antagonists，ACEIs/ARBs，diuretics），mean levels of systolic and diastolic blood pressure，total cholesterol（TC），high-density lipoprotein cholesterol（HDL-C），NLR，homocysteine，and left ventricular ejection fraction（LVEF）differed significantly across the control group and three cardiovascular risk subgroups（P<0.05），but mean body mass index（BMI），triglyceride，low-density lipoprotein cholesterol（LDL-C），ALT，creatinine，and fasting blood glucose levels did not（P>0.05）．Mean NLR increased successively in control group，low-，intermediate- and high-risk subgroups.Logistic regression analysis showed that age，systolic blood pressure，diastolic blood pressure，TC，LDL-C，HDL-C，NLR and LVEF were the influencing factors of Framingham Risk Score（P<0.05）．The results of ROC curve analysis showed that when NLR was 2.86，the Youden's index was the largest（0.560），the corresponding sensitivity was 0.796，the specificity was 0.764，and the area under ROC curve was 0.836〔95%CI （0.775，0.897）〕.Conclusion　NLR associated with Framingham Risk Score，and may has a certain predictive value for high-risk cardiovascular diseases.

Key words: Cardiovascular diseases, Hypertension, Leukocytes, Lymphocytes, Forecasting, Regression analysis, ROC curve