中性粒细胞/淋巴细胞比值与非瓣膜病心房颤动患者发生缺血性脑卒中关系的研究  

The study of neutrophil/lymphocyte ratio and its relationship with ischemic stroke in patients with non valvular atrial fibrillation

作　　者：黄锐[1] 黄从新[1] 童随阳 严莉[1] 徐斯驰 沈玉娇[1] 

机构地区：[1]武汉大学人民医院心内科,430060

出　　处：《疑难病杂志》2015年第10期996-999,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：国家科技支撑计划项目(No.2011BAI11B12)

摘　　要：目的探讨非瓣膜病心房颤动(AF)患者中性粒细胞与淋巴细胞比值(NLR)和缺血性脑卒中的关系。方法选择2013年4月—2015年4月心内科住院诊断为非瓣膜病心房颤动患者306例,根据近期是否发生缺血性脑卒中病史分为房颤合并缺血性脑卒中组(联合组)及单纯性AF组(单纯组),同时选择同期住院的正常窦性心律患者(112例)作为对照组。计算NLR四分位数间距,将AF患者分为NLR≥3.56组与NLR<3.56组。统计患者基本临床资料及入院24 h内实验室检查结果,24 h动态心电图及超声心动图检查,并进行相关性分析。结果联合组在高血压病史发生率、NLR、RDW、WBC水平与对照组和单纯组比较差异有统计学意义(P<0.01或0.05)。与单纯组比较,联合组除AST、Glu、Fib、HDL外,余指标比较差异均有统计学意义(P<0.01或0.05);联合组的WBC、N、L、NLR、RDW、ALT、D-D、NT-proBNP与对照组比较,差异均有统计学意义(P<0.01或0.05)。NLR>3.65组的性别、年龄、脑梗死史、HASBLED评分、CHADS2评分、CHA2DS2VASc评分与NLR<3.56组比较差异均有统计学意义(P<0.01或0.05)。多因素Logistic回归分析结果显示,高NLR、CHADS2评分、CHA2DS2VASc评分为房颤患者发生缺血性脑卒中的危险因素。NLR的ROC曲线下面积为0.718(P<0.001),最佳的诊断Cut-off值为2.79。结论非瓣膜病心房颤动患者NLR的增高和缺血性脑卒的发生可能密切相关。Objective To investigate the relationship between the ratio of neutrophil to lymphocyte （ NLR） and is-chemic stroke in patients with atrial fibrillation（ AF） of non valvular disease .Methods From 2013 April to 2015 April, 306 cases of non valvular atrial fibrillation patients were enrolled , according to whether the recent occurrence of ischemic stroke or not, they were divided into atrial fibrillation associated with ischemic stroke （combined group） and AF with non-cerebral is-chemic stroke （ simple group ） , and same period of hospitalized normal sinus rhythm patients （ 112 cases ） as the control group.Calculated the NLR four percentile interval , AF patients were divided into NLR greater than or equal to 3.56 group and NLR〈3.56 group.The basic clinical data and 24 h laboratory test, 24 h dynamic electrocardiogram and echocardiography were performed and the correlation analysis was carried out .Results The combined group ’ s history of hypertension occur-rence rate, NLR, RDW, WBC levels, compared with the control group and simple group, the difference was statistically significant （ P =0.01 or 0.05）.Compared with simple group except AST, Glu, Fib, HDL-C,rest indices’ differences were statistically significant in combined group（ P =0.01 or 0.05）; combined group’s WBC,N,L,NLR,RDW,ALT,D-D,and NT proBNP had statistically significant differences from control group （ P =0.01 or 0.05）.NLR〉3.65 group’ s sex,age,cerebral infarction history,HASBLED score,the CHADS2 score,CHA2DS2VASc score had statistics significance difference from NLR〈3.56 group and cerebral thrombus（ P =0.01 or 0.05）.Multivariate Logistic regression analysis showed that the risk factors of ischemic stroke in patients with atrial fibrillation were high NLR , CHADS2 and CHA2DS2VASc.The area under the NLR curve of ROC was 0.718（ P 〈0.001）,the best diagnostic cutoff value was 2.79.＆amp;nbsp;Conclusion The increase of NLR in patients with non valvular atrial fibrillation may be closely related to the

关 键 词：中性粒细胞/淋巴细胞比值 非瓣膜病心房颤动 缺血性脑卒中 

分 类 号：R541.75[医药卫生—心血管疾病]