中性粒细胞百分比与老年急性冠脉综合征患者发病风险的相关性分析  

Correlation between neutrophil percentage and acute coronary syndrome risk in elderly patients

作　　者：周翔 刘睿涵 刘昱彤 田璠[1] 张杰[1] 王小毛 曹剑[1] Zhou Xiang;Liu Ruihan;Liu Yutong;Tian Fan;Zhang Jie;Wang Xiaomao;Cao Jian(Department of the 4th Healthcare,the Second Medical Center,Chinese PLA General Hospital,National Clinical Research Center for Geriatric Diseases,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心保健四科,国家老年疾病临床医学研究中心,北京100853

出　　处：《中国心血管杂志》2025年第1期52-56,共5页Chinese Journal of Cardiovascular Medicine

基　　金：军队保健课题(21BJZ26)。

摘　　要：目的探讨中性粒细胞百分比(N%)与老年急性冠脉综合征(ACS)患者发病风险的相关性。方法回顾性分析2022年1月至2024年1月因疑似心绞痛于解放军总医院第一医学中心行冠状动脉造影术的老年患者临床资料,诊断为ACS或非ACS为研究终点。根据是否发生ACS,将患者分为ACS组和非ACS组。采用倾向性评分匹配法对两组患者进行1∶1匹配。通过logistic回归分析N%与老年ACS发病风险的相关性。结果共纳入1298例患者,其中ACS 1137例(87.6%),男性占比66.3%,中位年龄68.0(64.0,73.0)岁。进行PSM前,非ACS组与ACS组年龄、性别、糖尿病史、PCI史、C反应蛋白(CRP)、D-二聚体、空腹血糖(FBG)、估算的肾小球滤过率(eGRF)、N末端B型利钠肽原(NT-proBNP)、高密度脂蛋白胆固醇(HDL-C)、左心室射血分数(LVEF)和N%比较,差异均有统计学意义(均为P<0.05)。进行PSM后,非ACS组和ACS组各159例,ACS组N%高于非ACS组(Z=-3.579,P<0.001)。单因素logistic回归分析表明,N%与老年ACS患者发病风险相关(PSM前:OR=1.06,95%CI:1.04~1.07,P<0.001;PSM后:OR=1.04,95%CI:1.02~1.07,P=0.001)。校正所有协变量后,多因素logistic回归分析结果显示,高N%为老年ACS患者发病风险的独立危险因素(PSM前:OR=1.04,95%CI:1.02~1.06,P<0.001;PSM后:OR=1.04,95%CI:1.01~1.07,P=0.003)。结论高N%与老年ACS患者发病风险显著相关。Objective To investigate the correlation between the percentage of neutrophils(N%)and the risk of acute coronary syndrome(ACS)in elderly patients.Methods A retrospective analysis was conducted on the clinical data of elderly patients who underwent coronary angiography at the First Medical Center of the General Hospital of the People s Liberation Army from January 2022 to January 2024 due to suspected angina pectoris.The primary endpoint was the diagnosis of ACS or non-ACS.Patients were divided into ACS and non-ACS groups based on the occurrence of ACS.Propensity score matching(PSM)was used to match the two groups in a 1∶1 ratio.Logistic regression analysis was performed to assess the correlation between N%and the risk of ACS in elderly patients.Results A total of 1298 patients were included,of whom 1137(87.6%)were diagnosed with ACS.The male proportion was 66.3%,and the median age was 68.0(64.0,73.0)years old.Before PSM,significant differences were observed between the ACS and non-ACS groups in terms of age,gender,history of diabetes mellitus,history of percutaneous coronary intervention(PCI),C-reactive protein(CRP),D-dimer,fasting blood glucose(FBG),estimated glomerular filtration rate(eGFR),N-terminal pro-B-type natriuretic peptide(NT-proBNP),high-density lipoprotein cholesterol(HDL-C),left ventricular ejection fraction(LVEF),and N%(all P<0.05).After PSM,N%in the ACS group(159 cases)was higher than in the non-ACS group(159 cases)(Z=-3.579,P<0.001).Univariate logistic regression analysis showed that N%was associated with the risk of ACS in elderly patients(before PSM:OR=1.06,95%CI:1.04-1.07,P<0.001;after PSM:OR=1.04,95%CI:1.02-1.07,P=0.001).After adjusting for all covariates,multivariate logistic regression analysis revealed that elevated N%was an independent risk factor for ACS in elderly patients(before PSM:OR=1.04,95%CI:1.02-1.06,P<0.001;after PSM:OR=1.04,95%CI:1.01-1.07,P=0.003).Conclusions An elevated N%is significantly associated with an increased risk of ACS in elderly patients.

关 键 词：急性冠脉综合征 老年人 中性粒细胞百分比 相关性研究 

分 类 号：R54[医药卫生—心血管疾病]