血小板/淋巴细胞比值与非瓣膜性心房颤动患者左心耳血栓状态的相关性  

Relationship Between Platelet/Lymphocyte Ratio and Left Atrial Appendage Thrombogenic Milieu in Patients with Nonvalvular Atrial Fibrillation

作　　者：向伟 孔令云 李孝伟 陈玲玲 佘飞 何榕[1] 刘芳[1] Xiang Wei;Kong Lingyun;Li Xiaowei;Chen Lingling;She Fei;He Rong;Liu Fang(Department of Cardiology,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院心内科,清华大学临床医学院,北京市102218

出　　处：《中国超声医学杂志》2022年第11期1229-1233,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨血小板/淋巴细胞比值(PLR)与非瓣膜性心房颤动(NVAF)患者左心耳血栓状态(LAATM)的相关性。方法 选取178例NVAF患者,根据经食管超声心动图(TEE)检查结果分为LAATM组(45例)和非LAATM组(133例)。比较两组患者的基本临床资料和超声心动图参数。采用多因素Logistic回归分析评价NVAF患者LAATM的独立危险因素,通过受试者工作特征(ROC)曲线及曲线下面积评估PLR判断LAATM的准确度。结果 单因素分析结果显示,与非LAATM组患者相比,LAATM组患者心力衰竭病史、N末端B型脑钠肽前体(NT-proBNP)、肾小球滤过率(eGFR)、国际标准化比值(INR)、PLR水平(142.7 vs 115.1)及左心房内径(LAD)均较高,左心室射血分数(LVEF)较低,差异均具有统计学意义(P<0.05)。多因素回归分析显示PLR是NVAF患者LAATM的独立危险因素(OR=1.006,95%CI:1.002~1.011,P=0.008)。ROC曲线下面积为0.635(95%CI:0.539~0.732,P=0.007);当PLR=160.9时,NVAF患者可能存在LAATM(灵敏度为42.2%、特异度为84.2%)。结论 PLR是NVAF患者LAATM的独立影响因素。Objective To explore the relationship between platelet/lymphocyte ratio and left atrial appendage thrombogenic milieu(LAATM) in patients with nonvalvular atrial fibrillation(NVAF). Methods We retrospectively analyzed the data of 178 patients with NVAF. According to the results of transesophageal echocardiography, patients were divided into LAATM group(n=45) and non-LAATM group(n=133). Multivariate logistic regression was used to analyze whether PLR was an independent risk factor of LAATM in NVAF patients, and the value of PLR in judging the presence or absence of LAATM was evaluated through the ROC curve. Results The proportion of patients with, heart failure, N-terminal B-type brain natriuretic peptide precursor, estimated glomerular filtration rate, international normalized ratio, left atrial diameter and PLR level(142.7 vs. 115.1) were significantly higher in the LAATM group than those in the non-LAATM group, while the left ventricular ejection fraction was significantly lower(P<0.05). Multivariate regression analysis showed that PLR(OR=1.006,95%CI:1.002-1.011, P=0.008) was an independent risk factors of LAATM. The AUC of PLR for predicting LAATM from the ROC curve was 0.635(95%CI:0.539-0.732, P=0.007), the sensitivity was 42.2%, specificity was 84.2% with PLR= 160.9 for predicting LAATM in this patient cohort. Conclusions PLR is a risk factor of LAATM in patients with NVAF.

关 键 词：非瓣膜性心房颤动 血小板/淋巴细胞比值 左心耳 血栓 经食管超声心动图 

分 类 号：R541.75[医药卫生—心血管疾病]