中性粒细胞与淋巴细胞比值、D-二聚体、白细胞介素-6、干扰素-γ对急性Stanford B型主动脉夹层患者院内死亡风险的预测效能  

Predictive efficacy of neutrophil to lymphocyte ratio,D⁃dimer,interleukin⁃6 and interferon⁃γon risk of in⁃hospital death in patients with acute Stanford type B aortic dissection

作　　者：薛才广 江昆[1] 宋伟[1] 程思强[1] 郭建 Xue Caiguang;Jiang Kun;Song Wei;Cheng Siqiang;Guo Jian(Department of Cardiac and Vascular Surgery,the Second People’s Hospital of Liaocheng City,Liaocheng 252600,China)

机构地区：[1]山东省聊城市第二人民医院心脏大血管外科,252600

出　　处：《临床内科杂志》2024年第4期258-262,共5页Journal of Clinical Internal Medicine

基　　金：聊城市重点研发计划政策引导类项目(2023YD45)。

摘　　要：目的 探讨中性粒细胞与淋巴细胞比值(NLR)、D-二聚体(D-D)、白细胞介素(IL)-6、干扰素(IFN)-γ对急性Stanford B型主动脉夹层(AADB)患者院内死亡风险的预测效能。方法 根据院内终点事件发生情况,将86例AADB患者分为存活组71例和死亡组15例,比较两组患者NLR、D-D、IL-6、IFN-γ水平。采用Cox回归分析评估AADB患者院内死亡的影响因素;采用受试者工作特征(ROC)曲线分析NLR、D-D、IL-6、IFN-γ对AADB患者院内死亡的预测效能;采用相对风险值(RR)分析NLR、D-D、IL-6、IFN-γ阳性表达对AADB患者院内死亡风险的影响。结果 死亡组患者NLR、D-D、IL-6、IFN-γ水平均高于存活组(P<0.05)。Cox回归分析结果显示,NLR、D-D、IL-6、IFN-γ均为AADB患者院内死亡的独立危险因素(P<0.001)。NLR、D-D、IL-6、IFN-γ4者联合对AADB患者院内死亡的预测效能优于单项指标。NLR、D-D、IL-6、IFN-γ阳性表达AADB患者院内死亡率均高于对应指标阴性表达患者(P<0.001)。RR分析结果显示,NLR、D-D、IL-6、IFN-γ阳性表达均显著增加AADB患者的院内死亡风险(P<0.001)。结论 NLR、D-D、IL-6、IFN-γ是AADB患者院内死亡的独立预测因子,4者联合具有可靠的预测效能。Objective To investigate the predictive efficacy of neutrophil to lymphocyte ratio(NLR),D⁃dimer(D⁃D),interleukin(IL)⁃6 and interferon(IFN)⁃γon risk of in⁃hospital death in patients with acute Stanford type B aortic dissection(AADB).Methods A total of 86 patients with AADB were divided into survival group(71 cases)and death group(15 cases)according to occurrence of end⁃point events in hospital.NLR,D⁃D,IL⁃6 and IFN⁃γlevels between two groups were compared.Cox regression analysis was used to analyze influencing factors for in⁃hospital death in patients with AADB.Receiver operating characteristic(ROC)curve was used to analyze predictive efficacy of NLR,D⁃D,IL⁃6 and IFN⁃γon in⁃hospital death in patients with AADB.Relative risk value was used to analyze effect of positive expressions of NLR,D⁃D,IL⁃6 and IFN⁃γon risk of in⁃hospital death in patients with AADB.Results NLR,D⁃D,IL⁃6 and IFN⁃γlevels in patients of death group were higher than those in survival group(P<0.05).Cox regression analysis result showed that NLR,D⁃D,IL⁃6 and IFN⁃γwere all independent risk factors for in⁃hospital death in patients with AADB(P<0.001).The combined efficacy of NLR,D⁃D,IL⁃6,and IFN⁃γin predicting in-hospital death in patients with AADB was superior to single indicators.In⁃hospital mortality of patients with AADB with positive expression of NLR,D⁃D,IL⁃6 and IFN⁃γwere all higher than those of patients with negative expression of corresponding index(P<0.001).Risk value analysis showed that positive expression of NLR,D⁃D,IL⁃6 and IFN⁃γall significantly increased risk of in⁃hospital death in patients with AADB(P<0.001).Conclusion NLR,D⁃D,IL⁃6,IFN⁃γare independent predictors of in⁃hospital death in patients with AADB,combination of above 4 index has reliable predictive efficacy.

关 键 词：急性Stanford B型主动脉夹层 中性粒细胞与淋巴细胞比值 白细胞介素-6 D-二聚体 干扰素-Γ 院内死亡风险 预测效能 

分 类 号：R543.1[医药卫生—心血管疾病]