NLR与心脏移植近期预后的相关性  

Correlation Between NLR and Short-Term Prognosis of Heart Transplantation

作　　者：李浩琦 王志华[1] 胡俊龙[1] 孙俊杰[1] 陈志高 张晓雪[1] 刘前进 程兆云[1] LI Haoqi;WANG Zhihua;HU Junlong;SUN Junjie;CHEN Zhigao;ZHANG Xiaoxue;LIU Qianjin;CHENG Zhaoyun(Department of Cardiac Surgery,Central China Fuwai Hospital of Zhengzhou University,Zhengzhou 451464,China)

机构地区：[1]郑州大学华中阜外医院心外科,河南郑州451464

出　　处：《河南医学研究》2025年第6期986-990,共5页Henan Medical Research

基　　金：河南省医学科技攻关计划项目(LHGJ20220111)。

摘　　要：目的评价术前中性粒细胞与淋巴细胞比值(NLR)对原位心脏移植(HTx)近期预后的影响。方法回顾性分析2018年4月至2024年3月于郑州大学华中阜外医院接受HTx的44例终末期心力衰竭患者的临床资料,收集术前基线资料、术前最后1次中性粒细胞绝对计数、淋巴细胞绝对计数、单核细胞绝对计数、血小板绝对计数、手术资料及术后随访资料。通过构建受试者工作特征(ROC)曲线,计算ROC曲线下面积(AUC),并通过计算约登指数确定NLR界值,根据NLR界值分为高NLR组及低NLR组,对两组术前基线资料、围手术期资料及近期预后进行统计学分析。结果通过ROC曲线计算的NLR界值为3.494,高NLR组术后监护室停留时间长于低NLR组,差异有统计学意义(P<0.05),高NLR组机械通气时间长于低NLR组,差异有统计学意义(P<0.05),高NLR组术后3个月死亡率高于低NLR组,差异有统计学意义(P<0.05),高NLR组术后连续肾脏替代治疗(CRRT)使用率高于低NLR组,差异有统计学意义(P<0.05),两组性别、年龄、吸烟史、高血压史、术前血肌酐、术前总胆红素、术前使用主动脉内球囊反搏(IABP)、左室射血分数比较,差异无统计学意义(P>0.05),两组手术资料比较,差异无统计学意义(P>0.05)。结论术前高NLR与HTx后早期死亡及术后CRRT使用相关,具有一定的预测价值。Objective To evaluate the impact of preoperative neutrophil to lymphocyte ratio(NLR)on short-term prognosis in orthotopic heart transplantation(HTx).Methods A retrospective analysis was conducted on clinical data from 44 patients with end-stage heart failure who underwent orthotopic heart transplantation at Central China Fuwai Hospital of Zhengzhou University between April 2018 and March 2024.Preoperative baseline data,last absolute counts of neutrophils,lymphocytes,monocytes,platelets,surgical details,and postoperative follow-up data were collected.The receiver operating characteristic(ROC)curve was constructed to calculate the area under the curve(AUC),the Youden index was used to determine the NLR cutoff value,dividing patients into high NLR and low NLR groups,statistical analyses were performed on baseline data,perioperative data,and short-term prognosis.Results The cutoff value of NLR calculated by the ROC curve was 3.494.Compared with the low NLR group,the high NLR group had a longer postoperative length of stay in the intensive care unit,the difference was statistically significant(P<0.05).The mechanical ventilation time in the high NLR group was longer than that in the low NLR group,the difference was statistically significant(P<0.05).The 3-month postoperative mortality in the high NLR group was higher than that in the low NLR group,the difference was statistically significant(P<0.05).The utilization rate of continuous renal replacement therapy(CRRT)in the high NLR group was higher than that in the low NLR group,the difference was statistically significant(P<0.05).There were no statistically significant differences between the two groups in terms of gender,age,smoking history,hypertension history,preoperative serum creatinine,preoperative total bilirubin,preoperative use of intra-aortic balloon pump(IABP),and left ventricular ejection fraction(P>0.05).Also,there were no significant differences in surgical data between the two groups(P>0.05).Conclusion Preoperative high NLR is associated with early postope

关 键 词：终末期心脏病 心脏移植 预后 中性粒细胞 淋巴细胞 

分 类 号：R654.2[医药卫生—外科学]