中性粒细胞/淋巴细胞比值与大动脉粥样硬化型脑梗死主动脉弓钙化的相关性分析  

Neutrophil-to-lymphocyte ratio is associated with aortic arch calcification in large-artery atherosclerotic ischemic stroke patients

作　　者：周淑宇 王莉 蔡必扬 李军荣 ZHOU Shu-yu;WANG Li;CAI Bi-yang;LI Jun-rong(Department of Neurology,The Affiliated Jiangning Hospital of Nanjing Medical University,Nanjing 211000,Jiangsu,China;Department of Neurology,Jinling Hospital,Nanjing University School of Medicine/General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China;Department of Medical Imaging,Jinling Hospital,Jinling Hospital,Nanjing University School of Medicine/General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)

机构地区：[1]南京医科大学附属江宁医院神经内科,南京211000 [2]南京大学医学院附属金陵医院(东部战区总医院)神经内科,南京210002 [3]南京大学医学院附属金陵医院(东部战区总医院)放射诊断科,南京210002

出　　处：《医学研究生学报》2022年第4期371-375,共5页Journal of Medical Postgraduates

基　　金：江苏省“双创博士”项目(JNYYSC201901)。

摘　　要：目的 主动脉弓是动脉钙化的好发部位,主动脉弓钙化(AAC)程度往往能够反映动脉粥样硬化负荷。本研究旨在探索中性粒细胞/淋巴细胞比值(NLR)作为炎症指标,与AAC严重程度的相关性。方法 回顾性分析2010年1月至2013年6月在东部战区总医院神经内科住院的609例大动脉粥样硬化型脑梗死患者临床资料。通过颈部CTA检查,应用Agatston积分法对AAC进行定量测定,并依据严重程度将纳入患者进行分组。使用广义线性模型(有序概率)分析NLR与AAC严重程度的相关性。结果 依据AAC积分结果,患者被分为无钙化组115例(18.9%)、轻度钙化组126例(20.7%)及重度钙化组368例(60.4%)。NLR显示出随钙化严重程度增加而上升的趋势[2.14(1.61~2.91)vs 2.18(1.54~2.87)vs 2.33(1.78~3.41),P=0.047]。校正年龄及性别(模型1)后,NLR与AAC严重程度正相关(β=0.070±0.029,P=0.015)。这种相关性在模型2(校正年龄、性别、高血压、糖尿病及吸烟)中依然存在(β=0.070±0.029,P=0.017)。将NLR按四分位值分组后,最高值的NLR组与更严重的AAC显著相关(β=0.304±0.144,P=0.035)。结论 NLR为AAC的独立预测因子,能够反映AAC的严重程度。NLR有作为评估动脉钙化及动脉粥样硬化程度的生物学指标的潜在价值。Objective Aortic arch is a common site of artery calcification. Aortic arch calcification(AAC) has been proposed as an appropriate index for atherosclerosis burden. Inflammation plays a central role in atherogenesis. Neutrophil-to-lymphocyte ratio(NLR) has been suggested as a marker for inflammation. This study aimed to determine the association between NLR and AAC. Methods The clinical data of 609 patients with large artery atherosclerotic cerebral infarction hospitalized in the Department of Neurology of Jinling Hospital from January 2010 to June 2013 were retrospectively analyzed. AAC was quantified by neck CTA using the Agatston score method and included patients were grouped according to severity. Generalized linear model(ordinal probit) was performed to assess the association between NLR values and severity of AAC. Results There were 115(18.9%), 126(20.7%), and 368(60.4%) patients classified as without AAC, with mild AAC, and with severe AAC, respectively. Patients with severe AAC had the highest NLR values(2.33[1.78~3.41] vs 2.18[1.54-2.87] vs 2.14[1.61-2.91], P=0.047) compared to patients with mild AAC and without AAC. In age-and sex-adjusted model, NLR values were positively correlated with severity of AAC(β=0.070±0.029, P=0.015). The correlation is still significant(β=0.070±0.029, P=0.017) in multivariable-adjusted model. After NLR was divided into 4 groups according to quartile values, patients with the highest NLR were associated with severer AAC(β=0.304±0.144, P=0.035) compared to those with the lowest levels. Conclusion This study suggested that NLR may reflect the severity of AAC. NLR could be considered as a valuable predictor of the degree of artery calcification and atherosclerosis.

关 键 词：主动脉弓钙化 中性粒细胞/淋巴细胞比值 动脉粥样硬化 

分 类 号：R543[医药卫生—心血管疾病]