Study On The Correlation Between The Severity Of Coronary Artery Disease In ACS Patients And MHR, Non-HDL-C And The Distribution Of TCM Syndrome Types

Objective:To analyze the relationship between monocyte count / high density lipoprotein cholesterol ratio(MHR)and non high density lipoprotein cholesterol(non-HDL-C)and the severity of coronary lesions(Gensini score)in patients with acute coronary syndrome(ACS),and to explore the evaluation value and clinical significance of MHR and non-HDL-C on the severity of coronary atherosclerotic lesions in ACS patients The distribution of TCM syndromes in the degree of pathological changes was studied.Material and medthod:In this study,154 patients with acute coronary syndrome(ACS)and coronary angiography(CAG)were selected from the Department of Cardiology,Affiliated Hospital of Liaoning University of traditional Chinese medicine from September 2018 to November 2019.According to the scoring results,52 patients were divided into low-risk group(G There were 54 cases in moderate risk group(40≤Gensini score <75)and 48 cases in high risk group(Gensini score≥75).Record the general clinical data of the selected patients,such as age,gender,BMI,previous disease history(diabetes history,hypertension history),and treat the patients with TCM syndrome differentiation,and record the patients’ TCM syndrome differentiation.Immediately after admission,the patient took venous blood test for c Tn I or high-sensitivity troponin,blood routine test and renal function.After 12 hours of fasting,the patient took blood test for brain natriuretic peptide,liver function,blood lipid series and fasting blood glucose in the morning of the second day.The results of coronary angiography were evaluated by Gensini.The differences of MHR and non-HDL-C in each group were compared,and the distribution of TCM Syndrome Types in each group was summarized and analyzed by spss24.0.Results: 1.All ACS patients were divided into high risk group(Gensini score≥75),medium risk group(40≤Gensini score < 75)and low risk group(Gensini score < 40).The level of MHR and nonHDL-C was significantly higher than that of the lower grade group with the increase of severity of coronary lesions(P < 0.05).2.Monocyte(r = 0.752,P < 0.05),MHR(r = 0.773,P < 0.05)were positively correlated with the degree of coronary stenosis(Gensini score),HDL-C(r =-0.539,P < 0.05)was negatively correlated with the severity of coronary lesions,and the R value of MHR was higher than that of monocyte and the absolute value of HDL-C,indicating that the correlation between MHR and the severity of coronary lesions was stronger than that of single index.LDL-C(r = 0.211,P < 0.05),non-HDL-C(r = 0.271,P < 0.05)were positively correlated with the severity of coronary lesions(Gensini score),and the R value of non-HDL-C was higher than the R value of LDL-C,indicating that the non-HDL-C(TC-HDL-C)composite index was more correlated with the severity of coronary lesions than the LDL-C single index.3.ROC curve analysis shows that MHR and non-HDL-C can predict the occurrence of AMI.The cutoff value of MHR was 0.5188,the sensitivity was 74.7%,the specificity was 59.7%,and AUC was 0.686;the critical value of non-HDL-C was 2.69mmol/l;the sensitivity was 89.7%,the specificity was 34.3%,and AUC was 0.605.4.In 154 ACS patients,the highest frequency of phlegm and blood stasis syndrome was 56(36.36%),followed by 39(25.32%),22(14.29%),27(11.04%),15(9.74%)and 5(3.25%)respectively.Among them,phlegm and blood stasis syndrome,Qi deficiency and blood stasis syndrome and qi stagnation and blood stasis syndrome are the main syndrome types of acute coronary syndrome.The frequency of phlegm and blood stasis syndrome was the highest in 43 male patients(39.8%);in female patients,the distribution of main syndrome types in ACS was more average,12 times(26.1%)of qi deficiency and blood stasis syndrome,13 times(28.3%)of phlegm and blood stasis syndrome,11 times(23.9%)of qi stagnation and blood stasis syndrome.According to different age groups,the majority of the young group is empirical,the majority of the middle-aged group and the elderly group are empirical and the majority of the elderly group are deficiency and the majority of the elderly group.According to BMI classification,the frequency of phlegm and blood stasis syndrome is the highest in obesity group,and the distribution of syndrome types is the average in normal group.According to the degree of coronary artery stenosis,with the increase of the degree of coronary artery stenosis,the frequency of phlegm and blood stasis syndrome increased gradually,the syndrome of qi stagnation and blood stasis decreased gradually,while the syndrome of qi deficiency and blood stasis did not change significantly with the degree of coronary artery stenosis.5.There were differences in the degree of coronary stenosis among different TCM syndromes,and there were statistical differences in Gensini score between phlegm stasis syndrome,Qi deficiency and blood stasis syndrome and qi stagnation and blood stasis syndrome(P < 0.05).6.The difference of MHR between different TCM syndrome types was different.There was statistical difference between Qi deficiency and blood stasis group and Phlegm Blood stasis group and qi stagnation and blood stasis group(P < 0.05).7.There were different differences among different TCM syndrome types,among which nonHDL-C of phlegm and blood stasis syndrome had statistical significance compared with other TCM syndrome types(P < 0.05).Conclusion: 1.The main syndrome types of ACS are phlegm and blood stasis syndrome,Qi deficiency and blood stasis syndrome and qi stagnation and blood stasis syndrome.The main syndrome types of male patients are phlegm and blood stasis syndrome.The distribution of female patients is relatively average.The proportion of qi stagnation and blood stasis syndrome is more than that of male patients.The main syndrome of BMI overweight and obesity was phlegm and blood stasis.With the increase of age,there are more and more deficiency syndromes.2.The degree of coronary stenosis,MHR and non-HDL-C of different TCM Syndromes of ACS are different,among which the level of MHR and non-HDL-C of phlegm stasis syndrome is higher,and the degree of coronary stenosis is more serious and the risk is greater.3.MHR and non-HDL-C have a significant correlation with the degree of coronary artery stenosis in ACS patients,which is more advantageous than a single index in assessing the severity of coronary artery.4.MHR and non-HDL-C have certain predictive value for AMI in ACS patients.