红细胞分布宽度及中性粒细胞/淋巴细胞比值与急性前壁心肌梗死患者左心室收缩功能的关系  

Red cell distribution width and neutrophil-to-lymphocyte ratio predict left ventricular systolic function in patients with acute anterior ST-segment elevation myocardial infarction

作　　者：马小花 陈诚 李畅[1] 许盈盈 李勋[1] MA Xiao-hua;CHEN Cheng;LI Chang;XU Ying-ying;LI Xun(The First Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215006,China)

机构地区：[1]苏州大学附属第一医院,江苏苏州215006

出　　处：《岭南心血管病杂志》2018年第1期22-26,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨红细胞分布宽度及中性粒细胞/淋巴细胞比值与行直接经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗的急性ST段抬高型前壁心肌梗死患者左心室收缩功能的关系。方法选取2013年1月至2016年9月间胸痛症状出现<12 h而入院行直接PCI治疗的急性ST段抬高型前壁心肌梗死患者共178例,根据左心室射血分数将患者分为2组,左心室射血分数<50%的患者为I组,共95例;左心室射血分数≥50%的患者为Ⅱ组,共83例。采用Spearman检验对红细胞分布宽度及中性粒细胞/淋巴细胞比值与左心室收缩功能之间的关系进行相关分析。结果两组年龄、性别、体质量指数、肌酐、肌钙蛋白、低密度脂蛋白胆固醇等比较,差异无统计学意义(P>0.05),两组间的红细胞分布宽度[13.66%vs.13.00%,P<0.01]和中性粒细胞/淋巴细胞比值[5.39 vs.3.78,P=0.01]比较,差异均有统计学意义。对所有患者红细胞分布宽度及中性粒细胞/淋巴细胞比值与左心室收缩功能行相关性分析,结果显示左心室收缩功能与红细胞分布宽度及中性粒细胞/淋巴细胞比值均呈负相关(分别为r=-0.68,P<0.01和r=-0.28,P<0.01)。进一步对两组患者分别进行相关分析显示,I组患者的左心室收缩功能与红细胞分布宽度仍呈显著负相关(r=-0.67,P<0.01),而与中性粒细胞/淋巴细胞比值无显著相关性(r=-0.15,P=0.16);Ⅱ组的左心室收缩功能与红细胞分布宽度及中性粒细胞/淋巴细胞比值水平均无相关性(分别为r=-0.17,P=0.14和r=-0.15,P=0.18)。结论行直接PCI治疗的急性ST段抬高型前壁心肌梗死患者的左心室收缩功能随红细胞分布宽度及中性粒细胞/淋巴细胞比值升高而降低,且红细胞分布宽度可作为急性前壁心肌梗死患者出现左心室收缩功能障碍的预测因子。Objectives To investigate the relationship between red cell distribution width(RDW),neutrohil-to-lym?phocyte ratio(NLR)and left ventricular systolic function in acute anterior ST-segment elevation myocardial infarction(STEMI)patients who underwent primary percutaneous coronary intervention(PCI).Methods Totally78patients with acute anterior STEMI sympton onset within12hours treated with primary PCI from January2013to September2016were selected as objects.The patients were divided into two groups according to left ventricular ejection fraction(LVEF)on admission:ⅠGroup(systolic dysfunction,LVEF<50%,n=95)andⅡgroup(preserved left ventricle sys?tolic function,LVEF≥50%,n=83).Relationships between RDW,NLR and left ventricular systolic functions were analyzed.Results There was no statistically significant differences of age,gender,body mass index and concentra?tions of creatinine,troponin,low-density lipoprotein-cholesterol(LDL-C)between the two groups.RDW and NLR were significantly higher inⅠgroup compared toⅡgroup[13.66%vs.13.00%,P<0.01and5.39vs.3.78,P=0.01].Spearman correlation analysis showed that patients,left ventricular systolic function negatively correlated with RDW and NLR(r=-0.68,P<0.01;r=-0.28,P<0.01),and further analysis showed that,LVEF inⅠgroup negatively correlated with RDW(r=-0.67,P<0.01),while LVEF had no correlation with NLR(r=-0.15,P=0.16).LVEF inⅡgroup had no correlation with RDW and NLR(r=-0.17,P=0.14;r=-0.15,P=0.18).Conclusions For patients with acute anteri?or STEMI who underwent PCI,left ventricular systolic function decreases as RDW and NLR increase.And RDW can be seen as the early predictors of depressed left ventricular systolic function in patients with acute anterior STEMI.

关 键 词：心肌梗死 红细胞分布宽度 中性粒细胞/淋巴细胞比值 血管成形术 经腔 经皮冠状动脉 左心室收缩功能 

分 类 号：R542.22[医药卫生—心血管疾病]