中性粒细胞/淋巴细胞比例对急性前壁心肌梗死患者急性期左心功能不全的预测价值  

Prognostic value of the neutrophil-lymphocyte ratio in acute anterior myocardial infarction patients with acute left cardiac insufficiency

作　　者：孙筱笛[1] 刘闺男[2] 

机构地区：[1]中国医科大学附属第一医院老年心内科,沈阳110001 [2]中国医科大学附属第一医院心内科

出　　处：《临床心血管病杂志》2015年第3期302-306,共5页Journal of Clinical Cardiology

摘　　要：目的：探讨中性粒细胞与淋巴细胞比例（NLR）与急性前壁心肌梗死急性期左心功能不全之间的联系。方法：回顾性分析急性前壁心肌梗死患者121例,分为左心功能不全组和非左心功能不全组,对白细胞计数、中性粒细胞计数、中性粒细胞百分比、NLR及其他危险因素[如年龄、性别、糖尿病、高血压、吸烟、血脂达标、贫血、肾功能、药物治疗、冠状动脉（冠脉）病变情况和再灌注治疗情况]进行分析。结果：急性期左心功能不全组的白细胞计数、中性粒细胞计数、中性粒细胞百分比、NLR的绝对值较高（均P=0.000）。ROC曲线显示,NLR较其他指标能更准确地预测急性左心功能不全的发生。对年龄、估算肾小球率过滤（eGFR）、Syntax积分及PCI/CABG行多因素分析,结果显示以上各指标均为急性前壁心肌梗死后早期心功能不全的独立危险因素;白细胞计数、中性粒细胞计数、中性粒细胞百分比及NLR均为预测急性前壁心肌梗死合并急性期左心功能不全的独立预测因子,且NLR的OR值较高,为较强的独立预测因子（OR=7.005,95%CI=2.306~21.276,P=0.000）。结论：白细胞计数、中性粒细胞计数、中性粒细胞百分比及NLR均为急性前壁心肌梗死合并急性期左心功能不全的独立预测因子,且NLR预测准确度较高。Objective：To study the correlation between neutrophil-lymphocyte ratio（NLR）and left cardiac insufficiency in patients with acute anterior myocardial infarction.Method：A total of 121 cases with acute anterior myocardial infarction was included into left cardiac insufficiency group and non-left cardiac insufficiency group.WBC counts,neutrophils counts,the percentage of neutrophils,NLR and other risk factors including age,gender,diabetes mellitus,hypertension,smoking habit,blood lipid level,admission hemoglobin,endovascular recanalization therapy,medication treatment,coronary artery lesions assessment and eGFR were analyzed.Result：The WBC counts,neutrophils counts,percentage of neutrophils and NLR were higher in patients with left cardiac insufficiency（all P=0.000）.ROC showed that the NLR was a far more accurate predictor of left cardiac insufficiency than other factors.Multi-factor regression analysis showed that age,eGFR,Syntax score and PCI/CABG were independent risk factors for left cardiac insufficiency.The WBC counts,neutrophils counts,percentage of neutrophils and NLR were independent risk factors for acute anterior myocardial infarction complicated with left cardiac insufficiency,especially NLR had better veracity（OR=7.005,95%CI=2.306~21.276,P=0.000）.Conclusion：The WBC counts,neutrophils counts,percentage of neutrophils and NLR could be seen as prognostic factors of acute anterior myocardial infarction with acute left cardiac insufficiency.

关 键 词：中性粒细胞/淋巴细胞比例 急性前壁心肌梗死 左心功能不全 危险因素 

分 类 号：R541.1[医药卫生—心血管疾病]