RDW、NLR联合房颤负荷对起搏器术后阵发性房颤患者发生急性脑梗死的预测价值  

Predictive value of red cell distribution width,neutrophil to lymphocyte ratio combined with atrial fibrillation burden for acute cerebral embolism in patients with paroxysmal atrial fibrillation post-pacemakers

作　　者：秦景梅[1] 孔德玲[1] 于学坤 QIN Jingmei;KONG Deling;YU Xuekun(Tengzhou Central People's Hospital Affiliated to Jining Medical University,Tengzhou,Shandong 277500,China;Shanting District People's Hospital,Zaozhuang,Shandong 277200,China)

机构地区：[1]济宁医学院附属滕州市中心人民医院,山东滕州277500 [2]山东省枣庄市山亭区人民医院,山东枣庄277200

出　　处：《中国医学工程》2025年第3期68-71,共4页China Medical Engineering

摘　　要：目的 探讨置入双腔心脏起搏器患者中阵发性心房颤动(简称房颤)的发生率及红细胞分布宽度(RDW)、中性粒细胞/淋巴细胞比值(NLR)、房颤负荷对其发生急性脑梗死的预测价值。方法 117例置入双腔起搏器患者,分别于术后每6个月程控随访1次,共随访1年。筛选出发生阵发性房颤的40例患者作为观察组,2例发生永久性房颤退出研究,余75例未发生房颤患者作为对照组。分析比较两组RDW、NLR值及房颤负荷差异及各项指标与患者发生急性脑梗死的相关性。结果 所有患者均完成1年随访。两组患者术前RDW、NLR,术后6个月RDW比较差异无统计学意义(P>0.05)。观察组术后6个月NLR,术后12个月RDW、NLR均高于对照组(P<0.05);观察组术后6个月RDW与术前相比,数值有所增加,但差异无统计学意义(P>0.05),术后12个月RDW与术前相比,差异有统计学意义(P<0.05);观察组术后6个月、12个月NLR、房颤负荷与术前相比,随时间延长均有所升高,差异均有统计学意义(P<0.05)。Logistic回归分析表明,RDW、NLR、房颤负荷升高为阵发性房颤患者发生急性脑梗死的危险因素(O^R值分别为1.103、1.921、1.805,P<0.05)。结论 双腔心脏起搏器置入患者术后房颤和阵发性房颤发生并不少见;将RDW、NLR与房颤负荷联合可提高对阵发性房颤发生急性脑梗死风险的预测价值。【Objective】To explore the incidence of paroxysmal atrial fibrillation and the predictive value of red blood cell distribution width(RDW),neutrophil to lymphocyte ratio(NLR),and atrial fibrillation burden for acute cerebral infarction in patients with dual chamber pacemakers.【Methods】A total of 117 patients with dual chamber pacemakers were followed-up every 6 months after surgery for a total of 1 year.Forty patients with paroxysmal atrial fibrillation were selected as the observation group,two patients with permanent atrial fibrillation withdrew from the study,and the remaining 75 patients without atrial fibrillation were selected as the control group.The differences in RDW,NLR values,and atrial fibrillation burden between the two groups,as well as the correlation between various indicators and the occurrence of acute cerebral infarction in patients were analyzed and compared.【Results】All patients completed a one-year follow-up.Before operation there were no differences in RDW and NLR between the two groups,and there were no differences in RDW at 6 months after surgery(P>0.05).The observation group had higher NLR at 6 months after surgery,and higher RDW and NLR at 12 months after surgery compared with the control group(P<0.05).The observation group showed an increase in RDW at 6 months after surgery compared with preoperative levels,but the difference was not statistically significant(P>0.05);however,there was a statistically significant difference in RDW at 12 months after surgery compared with preoperative levels(P<0.05).The NLR and atrial fibrillation burden in the observation group increased with time at 6 and 12 months after surgery compared with before surgery,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that RDW,NLR and elevated atrial fibrillation burden were risk factors for acute cerebral infarction in patients with paroxysmal atrial fibrillation(O^R values of 1.103,1.921,1.805,respectively,P<0.05).【Conclusion】The incidences of atrial fib

关 键 词：红细胞分布宽度 中性粒细胞/淋巴细胞比值 房颤负荷 阵发性心房颤动 急性脑梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]