非动脉炎性视网膜中央动脉阻塞患者的部分外周血细胞变化  

Changes of some peripheral blood cells in patients with non-arteritis central retinal artery occlusion

作　　者：王小堂 雷涛 顾露露 王润生 张博 马腾 Wang Xiaotang;Lei Tao;Gu Lulu;Wang Runsheng;Zhang Bo;Ma Teng(Department of Ophthalmology,Xi'an People's Hospital(Xi'an Fourth Hospital),Xi'an 710004,China)

机构地区：[1]西安市人民医院(西安市第四医院)眼科,西安710004

出　　处：《中华眼底病杂志》2024年第8期593-597,共5页Chinese Journal of Ocular Fundus Diseases

基　　金：陕西省重点研发计划项目(2021SF-154);西安市科技计划项目(21YXYJ0043)。

摘　　要：目的观察非动脉炎性视网膜中央动脉阻塞(NA-CRAO)患者外周血中部分与炎症相关的血细胞变化。方法去回顾性临床研究。2019年7月至2021年7月于西安市人民医院(西安市第四医院)眼科住院治疗的NA-CRAO患者218例(NA-CRAO组)及同期常规体检者218名(对照组)纳入研究。两组受检者年龄(=0.60)、性别构成比(x=0.83)、体重指数(t=0.77)比较,差异均无统计学意义(P>0.05)。采集受检者空腹外周静脉血O.2ml,检测白细胞(WBC)、中性粒细胞(NEUT)、淋巴细胞(LYMPH)、红细胞(RBC)、RBC分布宽度(RDW)、血小板(PLT)、平均PLT体积(MPV)、大PLT比率(PLCR),计算NEUT/LYMPH比率(NLR)、PLT/LYMPH比率(PLR)。组间计量资料比较采用检验。对P<0.05的血细胞行多因素logistic回归分析。采用受试者工作特征曲线(ROC曲线)计算各炎症指标的曲线下面积(AUC)及其95%可信区间(95%CI),根据约登指数(灵敏度+特异性一1)确定最佳临界值。结果与对照组比较,NA-CRAO组患者WBC、NEUT、NLR、RDW、PLR升高,LYMPH、RBC降低,差异均有统计学意义(t=9.68、12.43、9.47、3.64、5.54、5.18、0.46,P<0.001);两组PLT、MPV、PLCR比较,差异无统计学意义(t=0.32、1.56、0.84,P>0.05)。多因素logistic回归分析结果显示,NLR是NA-CRAO发生的可能危险因素(比值比=2.51,95%CI0.780~0.859,P=0.031)。ROC曲线分析结果显示,NLR预测NA-CRAO的AUC为0.819,最佳临界值为3.05,灵敏度、特异性分别为59.2%、92.7%。结论NA-CRAO患者外周血细胞中NEUT明显升高,LYMPH减少;NLR是NA-CRAO发生的可能危险因素。Objectives sTo explore the changes of some peripheral blood cells related to inflammation in patients with non-arteritis central retinal artery occlusion(NA-CRAO).Methods A retrospective clinical study.From July 2019 to July 2021,a total of 218 patients with NA-CRAO hospitalized(NA-CRAO group)in Department of Ophthalmology,Xi'an People's Hospital(Xi'an Fourth Hospital)and 218 patients with routine physical examination(control group)during the same period were included in the study.There were no significant differences in age(t-0.60),sex composition ratio(2=0.83)and body mass index(t-0.77)between the two groups(P>0.05).0.2 ml fasting peripheral blood was collected from the subject,and white blood cells(WBC),neutrophils(NEUT),lymphocytes(LYMPH),red blood cells(RBC),RBC distribution width(RDW),platelets(PLT),mean PLT volume(MPV),and large PLT ratio(PLCR)were detected.The NEUT/LYMPH ratio(NLR)and PLT/LYMPH ratio(PLR)were calculated.t test was used to compare measurement data between groups.Multiple logistic regression analysis was performed for blood cells with P<0.05.The receiver operating characteristic curve(ROC curve)was used to calculate the area under the curve(AUC)and 95%confidence interval(95%CI)of each inflammatory indicator,and the optimal cutoff value was determined according to the Jorden index(sensitivity+specificity-1).Results Compared with control group,WBC,NEUT,NLR,RDW,PLR were increased in NA-CRAO group,while RBC and LYMPH were decreased,with statistical significance(t-9.68,12.43,9.47,3.64,5.54,5.18,0.46;P<0.001).There was no significant difference in PLT,MPV and PLCR between the two groups(t=0.32,1.56,0.84;P>0.05).Multivariate logistic regression analysis showed that NLR was a possible risk factor for the occurrence of NA-CRAO(odds ratio=2.51,95%CI 0.780-0.859,P=0.031).ROC curve analysis showed that the AUC predicted by NLR was 0.819,the optimal critical value was 3.05,and the sensitivity and specificity were 59.2%and 92.7%,respectively.Conclusions In peripheral blood cells of NA-CRAO patients,NEUT

关 键 词：非动脉炎性视网膜中央动脉阻塞 外周血 血细胞 炎症 

分 类 号：R774.1[医药卫生—眼科]