术前中性粒细胞与淋巴细胞比值与急性心肌梗死患者经皮冠状动脉介入治疗术后72 h内无创血流动力学指标的关系研究  

Relationship between Preoperative Neutrophil to Lymphocyte Ratio and Noninvasive Hemodynamic Index within 72 Hours after Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction

作　　者：李庆军[1] 李泽林[1] 温志桥[1] 梁妍 李娟[1] 刘善铭[1] 叶小敏 LI Qingjun;LI Zelin;WEN Zhiqiao;LIANG Yan;LI Juan;LIU Shanming;YE Xiaomin(The Central People's Hospital of Zhanjiang,Zhanjiang 524000,China)

机构地区：[1]湛江中心人民医院

出　　处：《实用心脑肺血管病杂志》2019年第6期29-34,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：湛江市科技计划项目(2016B01133)

摘　　要：背景 经皮冠状动脉介入治疗(PCI)术后血流动力学紊乱与心力衰竭的发生有关,而明确术前中性粒细胞与淋巴细胞比值(NLR)与PCI术后血流动力学的关系有助于降低心力衰竭发生风险。目的 探讨术前NLR与急性心肌梗死(AMI)患者PCI术后72h内无创血流动力学指标的关系。方法 选取2016年1月—2019年1月在湛江中心人民医院行PCI的AMI患者150例,根据NLR三分位数分为NLR<2.22者50例(A组)、2.22≤NLR≤3.84者50例(B组)、NLR>3.84者50例(C组)。比较3组患者一般资料、实验室检查指标〔包括白细胞计数(WBC)、血红蛋白(Hb)、血小板计数(PLT)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及超敏C反应蛋白(hs-CRP)〕、左心室射血分数(LVEF)、药物使用情况及PCI术后不同时间点无创血流动力学指标〔包括心率(HR)、收缩压(SBP)、舒张压(DBP)、心输出量(CO)、心脏指数(CI)及每搏输出量(SV)〕;术前NLR与AMI患者PCI术后72h内无创血流动力学指标的相关性分析采用Pearson相关分析。结果 (1)3组患者男性比例、体质指数(BMI)、合并症、吸烟率、Killip分级、Hb、PLT、TC、TG及LDL-C比较,差异无统计学意义(P>0.05)。B组和C组患者年龄大于A组,WBC、hs-CRP高于A组,HDL-C、LVEF低于A组(P<0.05);C组患者年龄大于B组,WBC、hs-CRP高于B组,HDL-C、LVEF低于B组(P<0.05)。(2)3组患者中使用他汀类药物、阿司匹林、β-受体阻滞剂、钙离子拮抗剂者所占比例比较,差异无统计学意义(P>0.05)。(3)时间与方法在HR、SBP、DBP、CO、CI及SV上存在交互作用(P<0.05);时间、方法在HR、SBP、DBP、CO、CI及SV上主效应显著(P<0.05)。PCI术后1、3、6、12、24、48、72h,B组和C组患者SBP、DBP高于A组,C组患者SBP、DBP高于B组(P<0.05)。PCI术后0.5、1、3、6、12、24、48、72h,B组和C组患者CO、SV小于A组,CI低于A组(P<0.05);C组患者CO小于B组,CI低于B组(P<0.05)。(Background Hemodynamic disorders after percutaneous coronary intervention(PCI)are associated with occurrence of heart failure,to clear the relationship between preoperative neutrophil to lymphocyte ratio(NLR)and hemodynamics after PCI is helpful to reduce the risk of heart failure. Objective To investigate the relationship between preoperative NLR and noninvasive hemodynamic index within 72 hours after PCI in patients with acute myocardial infarction (AMI). Methods A total of 150 AMI patients underwent PCI were selected in the Central People's Hospital of Zhanjiang from January 2016 to January 2019,and they were divided into A group(with NLR<2.22,n=50),B group(with 2.22 ≤ NLR ≤ 3.84,n=50)and C group(with NLR>3.84,n=50)according to the tertiles of NLR. General information, laboratory examination results(including WBC,Hb,PLT,TC,TG,HDL-C,LDL-C and hs-CRP),LVEF,drug usage and noninvasive hemodynamic index(including HR,SBP,DBP,CO,CI and SV)at different time points after PCI were compared in the three groups;Pearson correlation analysis was used to analyze the correlation between preoperative NLR and noninvasive hemodynamic index within 72 hours after PCI in patients with AMI. Results (1)There was no statistically significant difference in male proportion,BMI,comorbidity,smoking rate,Killip classification,Hb,PLT,TC,TG or LDL-C in the three groups(P>0.05).Age in groups B and C was statistically significantly elder than that in A group,WBC and hs-CRP in groups B and C were statistically significantly higher than those in A group,while HDL-C and LVEF in groups B and C were statistically significantly lower than those in A group(P<0.05);age in groups C was statistically significantly elder than that in B group,WBC and hs-CRP in C group were statistically significantly higher than those in B group,while HDL-C and LVEF in C group were statistically significantly lower than those in B group(P<0.05).(2)There was no statistically significant difference in proportion of patients using statins,aspirin,β acceptor blockers or

关 键 词：心肌梗死 中性粒细胞与淋巴细胞比值 经皮冠状动脉介入治疗 血流动力学 

分 类 号：R542.22[医药卫生—心血管疾病]