探讨中性粒细胞和淋巴细胞比值与经皮冠状动脉介入术后对比剂肾病的关系  

Relationship Between Neutrophil to Lymphocyte Ratio and Contrast-induced Nephropathy in Patients With Percutaneous Coronary Intervention

作　　者：黄勇先 郭俊瑾 朱晓明 徐艳 

机构地区：[1]无锡市锡山人民医院心内科,江苏省214011

出　　处：《中国循环杂志》2017年第9期874-876,共3页Chinese Circulation Journal

摘　　要：目的:探讨中性粒细胞和淋巴细胞比值(NLR)与经皮冠状动脉介入治疗(PCI)后对比剂对肾功能损害的关系。方法:入选我院2015-05至2016-12期间行PCI的患者176例,入院24 h内采血检测白细胞计数、中性粒细胞计数、淋巴细胞计数、血肌酐(SCr)、尿素氮(BUN)、尿酸(UA)、胱抑素C(CysC)等指标,并计算NLR。按NLR水平用三分位分组法将患者分为三组:低值组(NLR<1.60,n=58)、中值组(1.60≤NLR≤2.36,n=62)及高值组(NLR>2.36,n=56)。分别在PCI后48 h和72 h复查SCr及CysC,用Pearson相关分析探讨相关性,采用Logistic多因素回归分析判定NLR是否是对比剂肾病(CIN)的危险因素。结果:低值组、中值组和高值组的SCr及CycC水平较基线水平升高的绝对值的差异有统计学意义(P均<0.05)。Pearson相关分析显示,NLR与SCr及CysC升高均呈正相关(r分别为0.785、0.764,P均<0.05),Logistic回归分析显示NLR是CIN的独立危险因素(OR=4.152,95%CI:1.145~4.106)。结论 :NLR与对比剂肾功能损伤呈正相关,是CIN的独立危险因素。Objective： To investigate the relationship between neutrophil to lymphocyte ratio （NLR） and contrast-induced nephropathy （CIN） in patients with percutaneous coronary intervention （PCI）. Methods： A total of 176 patients received PCI in our hospital from 2015-05 to 2016-12 were enrolled. Blood levels of white blood cells （WBC）, neutrophils （N）, lymphocytes （L）; serum creatinine （SCr）, blood urea nitrogen （BUN）, uric acid （UA）, cystatin C （CysC） were examined within 24 h of admission and NLR was calculated. According to NLR, the patients were divided into 3 groups： Low NLR group, NLR〈1.60, n=58, Moderate NLR group, 1.60〈NLR〈2.36, n=62 and High NLR group, NLR〉2.36, n=56. SCr and CysC were re-examined at 48 h and 72 h after PCI. Pearson analysis was conducted for correlation study and Logistic regression analysis was used to identify whether NLR was the risk factor for CIN occurrence. Results： Compared with baseline condition, SCr and CysC were increased in all 3 groups, all P〈0.05. Pearson analysis indicated that NLR was positively related to SCr and CysC elevation （r=0.785 and t=0.764）, both P〈0.05; Logistic regression analysis presented that NLR was an independent risk factor for CIN occurrence. Conclusion： NLR was positively related to contrast induced kidney injury, it was the risk factor for CIN occurrence in PCI patients.

关 键 词：炎症 血管成形术 经皮、经腔冠状动脉 对比剂肾病 

分 类 号：R54[医药卫生—心血管疾病]