中性粒-淋巴细胞比值评估老年心肌梗死患者预后的价值  

Assessment value of neutrophil-lymphocyte ratio for prognosis in aged patients with acute myocardial infarction

作　　者：龙崇荣[1] 唐能华 苟代玉 

机构地区：[1]重庆市沙坪坝区人民医院内二科,重庆市400030 [2]重庆市沙坪坝区人民医院急诊科,重庆市400030

出　　处：《心血管康复医学杂志》2016年第4期378-381,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的：探讨中性粒-淋巴细胞比值（NLR）对老年急性ST段抬高型心肌梗死（STEMI）患者预后评估的价值。方法：选择本院收治的老年急性STEMI患者180例为研究对象,根据临床预后,分为存活组（152例）与死亡组（28例）。采用受试者工作特征（ROC）曲线评价死亡发生的最佳切入值,并通过Logistic回归分析死亡发生的危险因素。结果：死亡组NLR值明显高于存活组[（3.9±1.6）比（2.5±1.8）,P=0.03];Logistic回归分析显示NLR值升高是患者死亡的独立危险因素（OR=1.96,P=0.009）;Pearson相关性分析显示,急性STEMI患者NLR值与全球急性冠状动脉事件注册风险评分（GRACE评分）呈显著正相关（r=0.46,P=0.028）;而与左室射血分数（LVEF值）呈显著负相关（r=-0.31,P=0.023）。通过ROC曲线分析发现NLR的曲线下面积（AUC）为0.851（95%CI：0.786-0.905）,其最佳工作点（OOP）为3.3,提示NLR〉3.3时,此时判断急性STEMI患者预后不佳的精确率较高（敏感性为80.2%和特异性为86.8%）。结论：中性粒-淋巴细胞比值升高是老年急性ST段抬高型心肌梗死患者死亡发生的独立危险因素,可有效评估其预后。Objective：To explore assessment value of neutrophil-lymphocyte ratio（NLR）for prognosis in aged patients with acute ST-segment elevation myocardial infarction（STEMI）.Methods：A total of 180 aged acute STEMI inpatients were selected from our hospital.According to clinical prognosis outcome,they were divided into survival group（n=152）and death group（n=28）.Receiver operator characteristic curve（ROC）was used to identify the optimal cut-off value assessing death.Then Logistic regression analysis was used to analyse risk factors of death.Results：Compared with survival group,there was significant rise in NLR [（2.5±1.8）vs.（3.9±1.6）,P=0.03]in death group;Logistic regression analysis indicated that elevated NLR was independent risk factor of patient＇s death（OR=1.96,P=0.009）;Pearson correlation analysis indicated that NLR was significant positively correlated with Global Registry of Acute Coronary Events（GRACE）score（r=0.46,P=0.028）,and significant inversely correlated with left ventricular ejection fraction（LVEF）（r=-0.31,P=0.023）in acute STEMI patients.ROC analysis found that area under the curve（AUC）of NLR was 0.851（95%CI：0.786-0.905）,its optimum operating point（OOP）was 3.3,suggesting that when NLR3.3,the accuracy determining poor prognosis in acute STEMI patients was high（sensitivity was 80.2% and specificity was 86.8%）.Conclusion：Increased NLR value is an independent risk factor for death in aged patients with acute STEMI,which can effectively assess the prognosis.

关 键 词：心肌梗死 老年人 淋巴细胞 粒细胞 

分 类 号：R542.22[医药卫生—心血管疾病]