中性粒细胞和淋巴细胞的比值与冠状动脉血管成像对比剂肾病的相关性研究  

Neutrophil -to -lymphocyte ratio predicts contrast -induced nephropathy in patientsundergoing coronary computed tomographic angiography

作　　者：刘彤梅[1] 王政[1] 车琳[1] 朱贵家[1] 

机构地区：[1]黑龙江省医院心内科,黑龙江哈尔滨150036

出　　处：《中国急救医学》2015年第11期1017-1021,共5页Chinese Journal of Critical Care Medicine

基　　金：基金项目：黑龙江省卫生厅科研立项（2013354）

摘　　要：目的探讨冠状动脉血管成像（CCTA）对比剂肾病（CIN）和外周血中性粒细胞和淋巴细胞比值（NLR）的相关性。方法人选我院心内科行冠状动脉CTA检查的患者，检查前及检查后24h和48h均给予静脉采血，比较CIN组和非对比剂肾病（NCIN）组患者NLR等相关指标的变化。结果人选研究对象为382例，CIN为24例，NCIN为358例，CIN组NLR和超敏C-反应蛋白（hs—CRP）较NCIN组明显增高（P〈0．001）；慢性肾病患者CIN发生率较非慢性肾病患者高（r=0．281，P=0．012）；糖尿病患者CIN发生率较非糖尿病患者高（r=0．359，P〈0．001）。年龄、基础肾小球滤过率、NLR及左室射血分数（LVEF）是CIN的独立预测因素。结论CCTA检查患者NLR可能是并发CIN实用有效的预测因素。Objective We investigated the relationship between baseline neutrophil- to- lymphocyte ratio （ NLR ） and contrast - induced nephropathy （ CIN ） with computed tomagraphic angiography （CCTA）. Methods The study selected patients undergoing CCTA in Department of Cardiology in our hospital, giving venous blood pre - examination, 24 hour and 48 hour respectively, to see the changs related indicators, compare, NLR in CIN patients with non -CIN patients. Results In this study, a total of 382 patients were enrolled. A total of 24 patients developed CIN. Both NLR （ P 〈 0.001 ） and C - reactive protein （ P 〈 0. 001 ） levels were significantly higher in the CIN group when compared with the non - CIN group. There was a stronger correlation in patients with a known history of CKD （r =0.281, P =0.012） than in patients with no history of chronic kidney disease（ CKD）, and in patients with a history of diabetes meUitus（DM） than in patients with no history of DM （r = 0. 359, P 〈 0.001 ）. Multivariate logistic regression analysis revealed that advanced age, DM, baseline glomerular titration rate （GFR）, NLR, and left ventricular ejection fractions （LVEF） were independent predictors of CIN. Conclusion The NLR may be used as a simple and reliable indicator of CIN in patients who underwent CCTA.

关 键 词：对比剂肾病(CIN) 中性粒细胞和淋巴细胞的比值(NLR) 冠状动脉血管成像(CCTA) 

分 类 号：R543.3[医药卫生—心血管疾病]