炎症因子对全因死亡的预测价值研究:开滦集团8.3万职工6.9年随访结果  

Predictive Value of Inflammatory Factors on All Cause Mortality in Normal Population: 6.9 Years Follow-up Results in Kailuan Group for 83,000 Subjects

作　　者：杜鑫[1] 季春鹏[1] 张莹 施继红[1] 黄喆[1] 朱辰蕊[1] 李慧英[1] 魏晓明[1] 林黎明[1] 熊海亮[1] 刘妍[1] 吴寿岭[1] 

机构地区：[1]华北理工大学附属开滦总医院心内二科,河北省唐山市063000 [2]华北理工大学附属医院超声科

出　　处：《中国循环杂志》2016年第3期245-249,共5页Chinese Circulation Journal

摘　　要：目的：探讨炎症因子水平对全因死亡的预测价值。方法：采用前瞻性队列研究,以参加2006-07至2007-10开滦集团公司健康体检的在职及离、退休职工为研究对象,排除急性炎症及资料不全者,最终83 228名受试者纳入研究队列,每年收集1次员工死亡信息,末次随访时间为2013-12-31。将研究对象分别按基线白细胞计数（WBC）、中性粒细胞与淋巴细胞比率（NLR）、C反应蛋白（CRP）的四分位数分组,比较各组全因死亡率,并采用多因素Cox回归模型分析各组全因死亡的发生风险。结果：平均随访6.9年后,基线WBC第一、二、三、四四分位组的全因死亡率分别为4.2%、4.5%、4.5%和5.0%（P〈0.001）;基线NLR第一、二、三、四四分位组的全因死亡率分别为3.3%、3.6%、4.5%和6.7%（P〈0.001）;基线CRP第一、二、三、四四分位组的全因死亡率分别为3.0%、3.6%、4.8%和6.8%（P〈0.001）。多因素Cox回归分析结果显示,校正年龄、性别、腰围等混杂因素后,随着基线WBC、NLR和CRP水平升高,全因死亡的发生风险均呈递增趋势,且基线WBC、NLR、CRP第四四分位组发生全因死亡的风险分别为第一四分位组的1.17[95%可信区间（CI）：1.06~1.29]、1.44（95%CI：1.31~1.59）、1.33（95%CI：1.20~1.47）倍。结论：WBC、NLR和CRP水平均为全因死亡的独立预测因子。Objective： To explore the predictive value of inflammatory factors on all cause mortality in normal population. Methods： In our prospective cohort study, a total of 83,228 subjects from physical examination of Kailuan group from 2006-07 to 2007-10 were enrolled, nobody had acute inflammation. The death information was collected once per year and the last follow-up was conducted in 2013-12-31. According to baseline levels, white blood cells（WBC）, ratio of neutrophil/lymphocyte ratio（N/L） and C-reactive protein（CRP） were respectively divided into 4 Quartile groups; all cause mortality was compared among different groups and their risks were studied by multi-Cox regression analysis.Results： The average follow-up time was 6.9 years. All cause mortality in Quartile 1, Quartile 2, Quartile 3 and Quartile 4 groups for WBC were 4.2%, 4.5%, 4.5% and 5.0% respectively; for N/L were 3.3%, 3.6%, 4.5% and 6.7% respectively; for CRP were 3.0%, 3.6%, 4.8% and 6.8% respectively. Multi-Cox regression analysis indicated that with adjusted age, gender, waist and other confounders, by elevation of WBC, N/R and CRP, the risks of all cause mortality were increased accordingly, and the risks in Quartile 4 groups were higher than those in Quartile 1 groups as for WBC, it was 1.17-time（95% CI 1.06-1.29）; for N/L, it was 1.44-time（95% CI 1.31-1.59）; for CRP, it was 1.33-time（95% CI 1.20-1.47） respectively.Conclusion： Elevated WBC, N/R and CRP are independent risk factors for all cause mortality in normal population.

关 键 词：白细胞 中性粒细胞 淋巴细胞 C反应蛋白质 死亡原因 

分 类 号：R54[医药卫生—心血管疾病]