中性粒细胞计数与淋巴细胞计数比值与糖尿病合并心肌梗死患者PCI术后不良结局的相关性  

Association of Neutrophil to lymphocyte ratio with adverse outcomes after PCI in diabetic patients with myocardial infarction

作　　者：刘雨轩 刘素玲[2] Liu Yuxuan;Liu Suling(Medical College of Zhengzhou University,Zhengzhou 450052,China;The First Affliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学医学院,郑州450052 [2]郑州大学第一附属医院,郑州450052

出　　处：《临床医学》2023年第5期5-9,共5页Clinical Medicine

摘　　要：目的 探讨中性粒细胞与淋巴细胞计数比值(neutrophil/lymphocyte ratio,NLR)与糖尿病合并心肌梗死(AMI-DM)患者PCI术后不良结局的相关性。方法 选取2017年1月至2018年12月郑州大学第一附属医院收治的AMI-DM患者344例为研究对象,均于发病12 h内行急诊PCI手术。根据入院中性粒细胞/淋巴细胞比值(NLR)分为低NLR组(n=161)与高NLR组(n=183)。随访两组对应长期结局事件的发生情况,并用Cox回归分析NLR的水平与结局事件的关系。结果 低NLR组与高NLR组在总终点事件(19.3和49.2%,P<0.001)、心源性死亡(7.5%和25.1%,P<0.001)事件和再发心梗(13.7%和29.5%,P<0.001)中差异有统计学意义。在校正了年龄、脑血管病、吸烟史、肺部感染、血红蛋白、左心射血分数等多种混杂因素后,多因素Cox回归显示高NLR水平与总终点事件(HR=2.082,95%CI 1.335~3.247,P=0.001)、心源性死亡(HR=2.687,95%CI 1.329~5.433,P=0.006)及再发心梗(HR=1.807,95%CI 1.081~3.021,P=0.024)显著相关。结论 NLR的升高与AMI-DM患者的长期死亡事件发生率相关,并且NLR是预测AMI-DM患者的长期结局事件、心源性死亡事件及再发心肌梗死的独立危险因素。Objective To investigate the relationship between the neutrophil to lymphocyte ratio(NLR) and adverse outcomes after PCI in patients with diabetes mellitus complicated with myocardial infarction(AMI-DM).Methods A total of 344 AMI-DM patients admitted to the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2018 were selected as the research subjects.All patients underwent emergency PCI within 12 hours of onset.According to the admission neutrophil/lymphocyte ratio(NLR) measurement level,they were divided into low NLR group(n=161) and high NLR group(n=183).The two groups were followed up for long-term outcome events,and Cox regression was used to analyze the relationship between NLR levels and outcome events.Results The low-NLR and high-NLR groups were significantly different in total end point events(19.3 and 49.2%,P<0.001),cardiac death events(7.5 and 25.1%,P<0.001),and recurrent MI(13.7 and 29.5%,P<0.001).After adjusting for age,cerebrovascular disease,smoking history,pulmonary infection,hemoglobin,left ventricular ejection fraction,and other confounding factors,multivariate Cox regression showed that high NLR levels were significantly correlated with total end point(HR=2.082,95% CI 1.335-3.247,P=0.001),cardiac death(HR=2.687,95% CI 1.329-5.433,P=0.006),and recurrent myocardial infarction(HR=1.807,95% CI 1.081-3.021,P=0.024).Conclusions Increased NLR is correlated with the incidence of long-term death events in AMI-DM patients,and NLR is an independent risk factor for predicting long-term outcome events,cardiogenic death events and recurrent myocardial infarction in AMI-DM patients.

关 键 词：中性粒细胞/淋巴细胞比值 糖尿病 心肌梗死 心源性死亡 再发心肌梗死 

分 类 号：R542.22[医药卫生—心血管疾病] R587.1[医药卫生—内科学]