外周血中性粒细胞与淋巴细胞比值对急性冠脉综合征早期诊断的价值  

Value of peripheral blood neutrophil to lymphocyte ratio for the early diagnosis of acute coronary syndrome

作　　者：尹炳坚[1,2] 傅强[1] 严全能[1] 陈若峰 郭建浩 李志樑[1,2] 

机构地区：[1]南方医科大学珠江医院心血管内科,广东广州510282 [2]广东省佛山市顺德区北滘医院心血管内科,广东佛山528311

出　　处：《国际检验医学杂志》2015年第21期3105-3107,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨外周血中性粒细胞与淋巴细胞比值(NLR)对急性冠脉综合征(ACS)早期诊断的价值。方法选择疑似ACS的胸痛患者247例,包括急性ST段抬高型心肌梗死(STEMI)51例,急性非ST段抬高型心肌梗死(NSTEMI)42例,不稳定型心绞痛(UA)87例,非心源性胸痛(NCCP)67例。根据患者入院时白细胞计数及分类计数结果,计算并分析NLR对ACS的诊断灵敏度、特异度、阳性预测值、阴性预测值,同时分析NLR的受试者工作特征(ROC)曲线。结果所有患者中,UA患者所占比例最高,其余依次为NCCP、STEMI和NSTEMI。各组中性粒细胞百分比、白细胞计数变化趋势一致,由NCCP组、UA组、NSTEMI组到STEMI组依次升高,但中淋巴细胞百分比呈相反的变化趋势。NLR对ACS的诊断灵敏度、特异度、准确性、阳性预测值、阴性预测值高于白细胞计数。结论 NLR具有费用低廉、简便易行、结果稳定、易于重复及动态观察等优点,对ACS早期诊断、病情评估及预后判断有重要指导意义。Objective To investigate the peripheral blood neutrophil to lymphocyte ratio（NLR）for the early diagnosis of acute coronary syndrome（ACS）.Methods A total of 247 patients with suspected ACS and chest pain,including 51 cases with acute ST segment elevation myocardial infarction（STEMI）,42 cases with acute non-ST segment elevation myocardial infarction（NSTEMI）,87 cases with unstable angina pectoris（UA）and 67 cases with non-cardiogenic chest pain（NCCP）were enrolled and detected for white blood cells count and classification.The sensitivity,specificity,positive predictive value,negative predictive value,receiver operating characteristic（ROC）curve of NLR were analyzed.Results Among all patients,the most common was UA,followed by NCCP,STEMI and NSTEMI.Level of neutrophil proportion and white blood cell count were lowest in NCCP group,followed by UA,NSTEMI and STEMI group,but lymphocyte proportion was with the opposite change tendency.Diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of NLR for ACS were higher than white blood cell count.Conclusion NLR was with various advantages for the early diagnosis,prognosis evaluation and state of ACS.

关 键 词：中性粒细胞与淋巴细胞比值 急性冠脉综合征 早期诊断 

分 类 号：R541.4[医药卫生—心血管疾病]