中性粒细胞/淋巴细胞与老老年男性高血压患者颈动脉斑块及脑梗死的关系  

The relationship between neutrophil to lymphocyte ratio and incidence rate of carotid plaque,cerebral infarction in the very elderly male patients with hypertension

作　　者：孙晓楠[1] 王吉 骆雷鸣[1] 付士辉[1] 吴红梅[1] 张立华[1] SUN Xiao-nan;WANG Ji;LUO Lei-ming;FU Shi-hui;WU Hong-mei;ZHANG Li-hua(Department of Geriatric Cardiology,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心心血管内科,北京100853

出　　处：《武警后勤学院学报（医学版）》2021年第5期30-33,共4页Journal of Logistics University of PAP（Medical Sciences）

基　　金：中央保健课题(W2017BJ12)。

摘　　要：【目的】探讨老老年高血压患者中性粒细胞/淋巴细胞(neutrophil to lymphocyte ratio,NLR)水平与患者颈动脉斑块及脑梗死之间的关系。【方法】选取2016年10月—2019年12月在解放军总医院老年心血管内科就诊的年龄≥80岁的男性高血压患者238例,根据入选对象NLR水平四分位数将患者分为4组,比较不同组研究对象颈动脉情况及脑梗死发生情况并进行分析研究,通过多因素分析研究NLR与颈动脉斑块及脑梗死的关系。【结果】不同NLR水平组颈动脉斑块发生率分别为43.2%,59%,67.2%and74.7%(χ^(2)=12.33,P=0.007),较高NLR水平患者发生颈动脉斑块增加;颈动脉斑块组患者NLR明显高于不存在颈动脉斑块的患者(3.58±3.16 vs.2.50±1.54,P<0.05)。陈旧性脑梗的发生率也存在差异(χ^(2)=12.81,P<0.05)。NLR是影响该类患者斑块发生危险因素(OR=1.467,95%CI 1.154~1.883,P=0.003),受试者工作特征曲线(receiver operator characteristic curve,ROC)下面积(area under the curve,AUC)为0.641(95%CI 0.568~0.714,P=0.001),截断界值点为NLR=2.43,敏感度61%,特异度67%;NLR是脑梗死的危险因素(OR=1.153,95%CI 1.105~1.298,P=0.02),AUC为0.643(95%CI 0.566~0.715,P=0.01),截断界值点为NLR=2.43,敏感度67%,特异度56%。【结论】男性老老年高血压患者NLR>2.43是该类患者颈动脉斑块及梗死发生的良好预测,监测NLR这个简单快捷的指标能够对高血压患者进行初步的危险性分层。【Objective】To explore the relationship among neutrophil to lymphocyte ratio(NLR),carotid plaque and cerebral infarction in hypertensive patients in old age.【Methods】A total of 238 male hypertensive patients whose age was over 80 were enrolled in the Elderly Cardiovascular Medicine of the PLA General Hospital from Oct.2016 to Dec.2019.According to the quartile of NLR on admission,the patients were divided to four groups.The incidences of carotid plaque and cerebral infarction were followed up,analyzed,and studied.Multivariate regression was carried out to determine the relationship between NLR and carotid plaque or cerebral infarction.【Results】Carotid plaque incidence rates in groups 1-4 were 43.2%,59%,67.2%and 74.7%,respectively(χ^(2)=12.33,P=0.007),and carotid plaque increased in patients with higher NLR levels.The patients with carotid plaque had a significantly higher NLR than those without carotid plaque(3.58±3.16 VS 2.50±1.54,P<0.05).Incidence rates of cerebral infarction were different(χ^(2)=12.81,P<0.05).NLR was a risk factor for plaque(OR=1.467,95%CI 1.154~1.883,P=0.003).AUC of ROC curve was 0.641(95%CI:0.568~0.714,P=0.001),and the cut-off point of NLR was 2.43,with the sensitivity of 61.0%,and specificity of 67.1%.NLR was a risk factor for infarction(OR=1.153,95%CI 1.105~1.298,P=0.02),AUC of ROC curve was 0.643(95%CI:0.566~0.715,P=0.01),and the cut-off point of NLR was 2.43,with the sensitivity of 67%and specificity of 56%.【Conclusion】In age over 80 male hypertensive patients,NLR>2.43 is an predictor for carotid plaque and cerebral infarctio.The initial risk can be stratified onpatients with hypertension through monitoring NLR.

关 键 词：中性粒细胞/淋巴细胞 高血压 颈动脉斑块 老老年 

分 类 号：R544[医药卫生—心血管疾病]