中性粒细胞与淋巴细胞比值联合GRACE评分对急性冠状动脉综合征患者近期不良心血管事件的预测价值  

Predictive value of NLR combined with GRACE score for short-term adverse cardiovascular events in patients with acute coronary syndrome

作　　者：徐姝[1] 张彦红[1] 刘子菲 滕旭[1] 李阳 杨晓旭[1] XU Shu;ZHANG Yan-hong;LIU Zi-fei;TENG Xu;LI Yang;YANG Xiao-xu(Department of Geriatrics,The Second Affiliated Hospital of Shenyang Medical College,Shenyang 110000,China)

机构地区：[1]沈阳医学院附属第二医院干诊科,辽宁省沈阳市110000

出　　处：《中国心血管病研究》2020年第1期73-77,92,共6页Chinese Journal of Cardiovascular Research

摘　　要：目的探讨中性粒细胞与淋巴细胞比值(NLR)联合GRACE评分对急性冠状动脉综合征(ACS)患者对近期不良心血管事件的预测价值。方法选取2017年7月至2019年4月期间沈阳医学院附属第二医院收治的ACS患者132例,根据GRACE评分将患者分为低危组(48例)、中危组(40例)、高危组(44例),另根据随访期间是否发生主要不良心血管事件(MACE)将患者分为MACE组(25例)和非MACE组(107例)。收集患者的一般资料,检测血脂指标、心功能指标和NLR等。结果①低危组合并基础患者29例、占比60.24%,吸烟患者18例、占比37.50%,冠心病家族史患者12例,占比25.00%;中危组合并基础患者28例、占比70.00%,吸烟患者22例、占比55.00%,冠心病家族史患者12例,占比30.00%;高危组合并基础患者34例、占比77.27%,吸烟患者27例、占比61.36%,冠心病家族史患者15例,占比34.09%;同时高危组NT-proBNP、LVEDD、NLR高于中危组和低危组,LVEF低于中危组和低危组,差异均有统计学意义(P<0.05)。②不同预后的ACS患者MACE组中NT-proBNP(523.81±121.54)ng/L,LVEF(47.19±2.58)%,GRACE评分(158.67±34.52)分;非MACE组N T-proBNP(475.57±75.64)ng/L、LVEF(52.33±5.32)%、GRACE评分(121.58±30.21)分,经两组对比,MACE组NT-proBNP、GRACE评分均高于非MACE组,MACE组LVEF数据低于非MACE组,差异均有统计学意义(P<0.05)。③ACS患者MACE组回归系数LVEF为-0.548,0«值中GRACE评分为1.531,已成为近期发生MACE的主要危险因素(P<0.05)o®ACS近期MACE的预测价值,NLR敏感度76.00%,GRACE评分72.00%,NLR联合GRACE评分敏感度为88.79%,NLR特异度81.30%,GRACE评分特异度79.40%,NLR联合GRACE评分特异度为72.00%,则诊断为阳性。结论NLR与GRACE评分升高均是ACS患者近期发生MACE的危险因素,且对ACS近期MACE均有较高的预测价值,二者联合可进一步提高预测价值。Objective To investigate the predictive value of neutrophil to lymphocyte ratio(NLR)combined with GRACE score for short-term adverse cardiovascular events in patients with acute coronary syndrome(ACS).Methods 132 cases of patients with ACS treated during July 2017 to April 2019 in Shenyang Medical College Second Affiliated Hospital,according to the GRACE score were divided into low-risk group(48 cases),moderate group(40 cases)and high-risk group(44 cases)and based on during the follow-up period whether major adverse cardiovascular events(MACE)occurred the patients were divided into the MACE group(25 cases)and the non-MACE group(107 cases).General data of patients were collected and the indicators of blood lipid,cardiac function and NLR were detected.Results(1)29 patients with low-risk combination and basic disease,accounting for 60.24%;18 patients with smoking,accounting for 37.50%;12 patients with family history of coronary heart disease,accounting for 25.00%;28 patients with medium-risk combination and basic disease accounted for 70.00%,22 patients with smoking disease accounted for 55.00%and 12 patients with family history of coronary heart disease accounted for 30.00%.There were 34 patients with high-risk combination and basic disease,accounting for 77.27%,27 patients with smoking,accounting for 61.36%and 15 patients with family history of coronary heart disease,accounting for 34.09%.Meanwhile,NT-proBNP,LVEDD and NLR in the high-risk group were higher than those in the medium-risk group and low-risk group and LVEF was lower than those in the medium-risk group and low-risk group,the difference was statistically significant(P<0.05).⑵NT-proBNP(523.81±121.54)ng/L,LVEF(7.19±2.58)%and GRACE score(15&67±34.52)in the MACE group of ACS patients with different prognosis.NT-proBNP(475.57±75.64)ng/L,LVEF(52.33±5.32)%and GRACE scores(121.58±30.21)in the non-mace group were compared with the non・mace group and LVEF scores in the MACE group were lower than those in the non-mace group,with statistically significant

关 键 词：急性冠状动脉综合征 中性粒细胞与淋巴细胞比值 全球急性冠状动脉事件注册研究评分 心血管事件 

分 类 号：R543.3[医药卫生—心血管疾病]