目的 研究单核细胞/高密度脂蛋白比值（MHR）对免疫球蛋白A肾病（IgAN）患者肾小球硬化严重程度的预测价值。方法 回顾性分析2016年1月—2022年6月龙岩人民医院收治的296例IgAN患者的临床和肾脏病理资料,参照牛津分型将患者分为无肾小球节段性硬化组（S0组）、有肾小球节段性硬化组（S1组）及球性硬化组;根据Katafuchi肾小球积分将患者分为低三分位组、中三分位组及高三分位组。比较不同肾小球硬化程度和不同Katafuchi肾小球积分患者的MHR水平,对MHR与Katafuchi肾小球积分的关系进行相关性分析,绘制受试者操作特征（ROC）曲线分析MHR对肾小球硬化程度的预测效能。结果 S1组和球性硬化组的单核细胞计数分别为（0.41±0.11）×10⁹ /L、（0.45±0.10）×10⁹ /L,均高于S0组的（0.30±0.06）×10⁹ /L,对比差异有统计学意义（t₁=10.381,P₁<0.001;t₂=12.169,P₂<0.001）,球性硬化组的HDL水平为（1.14±0.16）mmoL/L,低于S0组（1.26±0.24）mmoL/L（t₂=2.992,P₂=0.003）。S1组和球性硬化组的MHR为（0.36±0.04）、（0.44±0.05）,大于S0组的（0.24±0.02）,对比差异有统计学意义（t₁=37.852,P₁<0.001;t₂=42.037,P₂<0.001）,球性硬化组的MHR大于S1组（t₃=9.673,P₃<0.001）。中三分位组和高三分位组的单核细胞计数为（0.34±0.06）×10⁹ /L、（0.48±0.10）×10⁹ /L,高于低三分位组的（0.27±0.05）×10⁹ /L,对比差异有统计学意义（t₁=9.017,P₁<0.001;t₂=20.080,P₂<0.001）,高三分位组的单核细胞计数高于中三分位组（t₃=8.855,P₃<0.001）。高三分位组的HDL水平为（0.96±0.12）mmoL/L,低于低三分位组的（1.23±0.21）mmoL/L和中三分位组的（1.19±0.16）mmoL/L,对比差异有统计学意义（t₂=8.132,P₂<0.001;t₃=7.954,P₃<0.001）。高三分位组的MHR为（0.49±0.07）,大于低三分位组的（0.25±0.03）和中三分位组（0.26±0.08）,对比差异有统计学意义（t₂=35.382,P₂<0.001;t₃=15.146,P₃<0.001）。相关性分析显示,单核细胞与Katafuchi肾小球积分呈正相关（r=0.58,P<0.05）,HDL与Katafuchi肾小球积分呈负相关（r=-0.52,P<0.05）,MHR与Katafuchi肾小球积分呈正相关（r=0.66,P<0.05）。MHR预测肾小球节段性硬化的曲线下面积（AUC）为0.609（95%CI：0.325~0.917）,此时截断值为0.29,灵敏度为68.42%,特异度为65.45%。MHR预测球性硬化的AUC为0.735（95%CI：0.527~1.001）,此时截断值为0.40,灵敏度为73.08%,特异度为66.14%。结论 MHR在预测IgAN患者肾小球硬化程度方面具有潜能。

Objective To explore predictive value of the monocyte / high-density lipoprotein ratio（MHR）on the severity of glomerulosclerosis in patients with immunoglobulin A nephropathy（IgAN）．Methods The clinical and renal pathological data of 296 IgAN patients admitted to Longyan People's Hospital from January 2016 to June 2022 were analyzed retrospectively,and the patients were divided into no segmental sclerosis group（S0）,segment sclerosis group（S1）and glomerular sclerosis group according to Oxford classification;the patients were divided into low group,middle group and high group according to Katafuchi score．MHR levels in patients with different degrees of glomerular sclerosis and different Katafuchi score were compared,the relationship between MHR and Katafuchi glomerular integration was analyzed,and ROC curves were drawn to analyze the predictive efficacy of MHR on the degree of glomerular sclerosis．Results Monocyte counts in the S1 and glomerular sclerosis groups [（0.41±0.11）10⁹ /L,（0.45±0.10）10⁹ /L] were all significantly higher than the S0 group（0.30±0.06）10⁹ /L,with statistically significant difference（t₁=10.381,P₁<0.001,t₂=12.169,P₂<0.001）．The HDL level（1.14±0.16）mmoL / L was significantly lower than that in the S0 group（1.26±0.24）mmoL / L（t₂=2.992,P₂=0.003）．The MHR in S1 and glomerular sclerosis group[（0.36±0.04）,（0.44±0.05）] were significantly greater than S0（0.24±0.02）（t₁=37.852,P₁<0.001,t₂=42.037,P₂<0.001）,and the MHR in glomerular sclerosis group was significantly greater than that of S1（t₃=9.673,P₃<0.001）．The monocyte counts of middle and high group[（0.34±0.06）10⁹ /L,（0.48±0.10）10⁹ /L] were significantly higher than the low group（0.27±0.05）10⁹ /L（t₁=9.017,P₁<0.001;t₂=20.080,P₂<0.001）and high group was significantly higher than middle group（t₃=8.855,P₃<0.001）．The HDL level of high group（0.96±0.12）mmoL/L was significantly lower than the low group（1.23±0.21）mmoL/L and middle group（1.19±0.16）mmoL/L,with statistically significance（t₂=8.132,P₂<0.001,t₃=7.954,P₃<0.001）．The MHR（0.49±0.07）in the high group was significantly greater than the low group（0.25±0.03）and middle group（0.26±0.08）,with statistically significance（t₂=35.382,P₂<0.001,t₃=15.146,P₃<0.001）．Correlation analysis showed that monocytes were positively correlated with Katafuchi score（r=0.58,P<0.05）,HDL negatively with Katafuchi score（r=-0.52,P<0.05）,and MHR positively with Katafuchi score（r=0.66,P<0.05）．The AUC of MHR predicting segmental sclerosis was 0.609（95%CI：0.325~0.917）,when the cut-off was 0.29,sensitivity was 68.42% and specificity of 65.45%．The AUC of MHR predicting glomerulosclerosis was 0.735（95%CI：0.527~1.001）,when the cut-off was 0.40,sensitivity was 73.08% and specificity was 66.14%．Conclusions MHR has the potential in predicting the degree of glomerulosclerosis in IgAN patients．

目的 探讨接受冠状动脉造影患者的中性粒细胞-淋巴细胞比值（NLR）、血小板-淋巴细胞比值（PLR）和单核细胞-淋巴细胞比值（MLR）与冠状动脉疾病（CAD）严重程度的关系。方法 收集2021年1月—2021年12月在六安市人民医院接受冠状动脉造影的150例急性冠脉综合征（ACS）患者。CAD的严重程度通过Gensini评分进行评估,150例ACS患者根据评分被分为轻度病变组（≤14分,41例）、中度病变组（15~47分,69例）和重度病变组（≥48分,40例）。比较3组的临床指标,采用相关统计学分析NLR、PLR、MLR与CAD严重性（Gensini评分）的相关性。结果 纳入研究的150例患者的平均年龄为（66.49±11.43）岁,男性占67.3%。在重度病变组,NLR和PLR值高于其他两组。在Pearson相关性检验中,Gensini评分与NLR呈正相关（r=0.319,P<0.001）,然而,Gensini评分与MLR、PLR之间无相关性（P>0.05）。在Logistic回归分析中,NLR（OR：1.306,95%CI：0.107~0.427）是CAD的独立危险因素。在ROC曲线分析中,发现NLR的曲线下面积最高,为0.723（95%CI：0.629~0.817,P<0.001）,NLR≥0.25为识别CAD存在的最佳临界值,灵敏度为78.49%,特异度为60.26%。结论 根据Gensini评分,NLR与CAD的严重程度呈正相关,而研究中未观察到MLR、PLR与CAD严重程度之间的关联。

Objective To explore the correlation of neutrophil-to-lymphocyte ratio（NLR）,platelet-to-lymphocyte ratio（PLR）,monocyte-to-lymphocyte ratio（MLR）with coronary artery disease（CAD）severity in patients undergoing coronary angiography．Methods A total of 150 patients with acute coronary syndrome（ACS）who underwent coronary angiography in Lu'an People's Hospital from January 2021 to December 2021 were enrolled．The severity of CAD was assessed by Gensini score,according to the score,150 patients with ACS were divided into mild disease group（≤14 points,41 cases）,moderate disease group（15-47 points,69 cases）and severe disease group（≥48 points,40 cases）．Clinical indicators of the three groups were compared,and related statistics were used to analyze the correlation between NLR,PLR,MLR and the severity of coronary artery lesions（Gensini score）．Results The average age of selected 150 patients was（66.49±11.43）,67.3% were male．In the severe disease group,NLR,PLR values were higher than the other two groups．A positive significant correlation was found between Gensini score and NLR（r=0.319,P<0.001）by Pearson's correlation test．However,no correlation was found between Gensini score and MLR and PLR（P>0.05）．In the Logistic regression analysis,NLR（OR：1.306,95% CI：0.107-0.427）was the independent risk factor of CAD．In receiver operating characteristic curve analysis,NLR was found to have highest area under the curve at 0.723（95% CI：0.629-0.817,P<0.001）,with an optimal cut-off value of 0.25,predicting the severe coronary lesion with a sensitivity of 60.26% and specificity of 78.49%．Conclusions The NLR is positively correlated with the severity of CAD．No correlation between MLR,PLR and severity of CAD in the cohort were observed．

目的 探讨血浆D-二聚体及纤维蛋白原在社区获得性肺炎患者严重程度评估的应用价值。方法 收集110例社区获得性肺炎患者的临床资料,根据CURB-65评分标准对患者进行分组,分别测定患者血浆D-二聚体及纤维蛋白原水平,比较其在不同分组间的差异及通过ROC曲线了解其在重症社区获得性肺炎诊断中的价值。结果 不同CURB-65分组间D-二聚体、纤维蛋白原水平比较差异有统计学意义(P<0.05),重症肺炎组D-二聚体、纤维蛋白原水平明显高于非重症肺炎组(P<0.05)。ROC曲线显示入院D-二聚体、纤维蛋白原水平诊断重症肺炎曲线下面积(AUC)分别为0.815、0.777。结论 血浆D-二聚体及纤维蛋白原可以有效评估社区获得性肺炎患者病情的严重程度,其是诊断重症肺炎的一个良好指标。

Objective To evaluate the prediction and evaluation of plasma D-dimer and fibrinogen levels upon the severity of community acquired pneumonia(CAP). Methods Clinical variables of 180 patients with CAP were evaluated and divided into different groups by CURB65.Plasma D-dimer and fibrinogen were measured to compare their levels among different groups and evaluate the prediction in the diagnosis of the severe CAP by ROC curve. Results The mean D-dimer and fibrinogen level were different significantly among different CURB65 groups. D-dimer and fibrinogen level of severe CAP were significantly higher than non-serious pnrumonia group. The area under the curve of the D-dimer, fibrinogen in the diagnosis of severe pneumonia were 0.815, 0.777. Conclusion Plasma D-dimer and fibrinogen can effectively evaluate the severity of illness in patients with community acquired pneumonia and they could be useful for assessment of the severity of CAP.