中性粒细胞/淋巴细胞比值与原发性高血压患者24小时动态血压变异性及昼夜节律的关联  

Association of neutrophil/lymphocyte ratio with ambulatory blood pressure variability and circadian rhythm in patients with essential hypertension

作　　者：汪驰 童锴 穆洋 徐勇 王晶 WANG Chi;TONG Kai;MU Yang;XU Yong;WANG Jing(Department of Cardiology,the Sixth Medical Center of Chinese PLA General Hospital,Beijing 100048,China)

机构地区：[1]中国人民解放军总医院第六医学中心心血管病医学部,110048 [2]海军第971医院心血管内科

出　　处：《心肺血管病杂志》2024年第5期451-456,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家重点研发计划主动健康和老龄化科技应对专项(2020YFC2007305)。

摘　　要：目的:探究中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)与原发性高血压患者24h动态血压变异性及血压昼夜节律的关联。方法:本研究纳入2020年1月至2021年1月,在解放军总医院第一医学中心门诊就诊的原发性高血压患者。使用标准差(standard deviation,SD)、变异系数(coefficient of variation,CV)和独立于均值的变异系数(variation independent of mean,VIM)评估患者的动态血压变异性。使用多元线性回归分析探究NLR与动态血压变异性的关联,并使用多因素Logistic回归分析探究NLR与发生非杓型或反杓型血压节律的关联。结果:研究共纳入936例原发性高血压患者,校正了相关混杂因素进行的多元线性回归分析显示,NLR与高血压患者的24h收缩压SD(B=0.25)、CV(B=0.98)、VIM(B=0.15)、舒张压CV(B=1.23),日间收缩压SD(B=0.62)、CV(B=1.11)、VIM(B=0.30)、舒张压CV(B=0.99),和夜间收缩压SD(B=0.69)、CV(B=1.39)、VIM(B=0.29)、舒张压SD(B=1.54)、CV(B=1.72)、VIM(B=0.42)均呈线性相关。多因素Logistic回归分析显示,与NLR第一分位组相比,第四分位组与出现收缩压非杓型或反杓型血压节律风险升高93%有关(OR=1.84,95%CI:1.11~3.03)。结论:NLR与原发性高血压患者动态血压变异性呈显著正相关,NLR升高与出现收缩压非杓型或反杓型血压节律风险升高显著相关。Objective:We aim to investigate the association of neutrophil/lymphocyte ratio(NLR)with ambulatory blood pressure variability(BPV)and blood pressure circadian rhythm in patients with essential hypertension.Methods:We included patients with essential hypertension who were admitted in the First Center of Chinese PLA General Hospital during January 2020 to January 2021.NLR was defined as lymphocyte count divided by neutrophil count.We used standard deviation(SD),coefficient of variation(CV),and variation independent of mean(VIM)to evaluate the ambulatory BPV.We used multiple linear regression to examine the association between NLR and ambulatory BPV,and multivariable logistic regression to examine the association of NLR with non-dipping and reverse-dipping blood pressure.Results:A total of 936 patients with essential hypertension were included in the current study.After adjusting for potential confounders,we found positive linear association of NLR with 24h SBP SD(B=0.25),SBP-CV(B=0.98),SBP-VIM(B=0.15),DBP CV(B=1.23),diurnal SBP-SD(B=0.62),SBP-CV(B=1.11),SBP-VIM(B=0.30),DBP-CV(B=0.99),and nocturnal SBP-SD(B=0.69),SBP-CV(B=1.39),SBP-VIM(B=0.29),DBP-SD(B=1.54),DBP-CV(B=1.72),DBP-VIM(B=0.42).Multivariable logistic regression showed that compared with the lowest quartile of NLR,the highest quartile of NLR was associated with 93%higher risk of non-dipping and reverse-dipping blood pressure(OR=1.84,95%CI:1.84,1.11-3.03).Conclusions:NLR was positively and linearly associated with ambulatory BPV.Elevated NLR was associated with higher risk of non-dipping and reverse-dipping blood pressure.

关 键 词：原发性高血压 血压变异性 血压昼夜节律 炎症 

分 类 号：R54[医药卫生—心血管疾病]