中性粒细胞-淋巴细胞比值在冠心病经皮冠状动脉介入治疗中的临床意义

王玎羽; 林菁榕; 崔玉敏; 赵东英; 徐寅实; 王雪玲; 谢翔

doi:10.11659/jjssx.08E022134

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中性粒细胞-淋巴细胞比值在冠心病经皮冠状动脉介入治疗中的临床意义

临床研究 | 更新时间：2023-07-17

- 中性粒细胞-淋巴细胞比值在冠心病经皮冠状动脉介入治疗中的临床意义
- Clinical significance of neutrophil lymphocyte ratio in percutaneous coronary intervention for coronary heart disease
- 局解手术学杂志 2023年32卷第7期页码：607-611
- 作者机构：
  
  1.航天中心医院教育处，北京100049
  2.清华大学附属第二医院国税局门诊部，北京100038
  3.航天中心医院医务部，北京100049
  4.北京中西医结合医院心内科，北京 100039
  5.新疆医科大学第一附属医院心脏中心，新疆乌鲁木齐830011
- 作者简介：
  
  谢翔，E-mail：sutjm95@163.com
- 基金信息：
  
  新疆维吾尔自治区科技支疆项目(2019E0278)
- DOI：10.11659/jjssx.08E022134
  中图分类号： R541.4
- 纸质出版日期：2023-07-25，
  
  收稿日期：2022-08-24，
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王玎羽,林菁榕,崔玉敏等.中性粒细胞-淋巴细胞比值在冠心病经皮冠状动脉介入治疗中的临床意义[J].局解手术学杂志,2023,32(07):607-611.

WANG Ding-yu,LIN Jing-rong,CUI Yu-min,et al.Clinical significance of neutrophil lymphocyte ratio in percutaneous coronary intervention for coronary heart disease[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(07):607-611.
王玎羽,林菁榕,崔玉敏等.中性粒细胞-淋巴细胞比值在冠心病经皮冠状动脉介入治疗中的临床意义[J].局解手术学杂志,2023,32(07):607-611. DOI： 10.11659/jjssx.08E022134.

WANG Ding-yu,LIN Jing-rong,CUI Yu-min,et al.Clinical significance of neutrophil lymphocyte ratio in percutaneous coronary intervention for coronary heart disease[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(07):607-611. DOI： 10.11659/jjssx.08E022134.

摘要

目的

探讨中性粒细胞-淋巴细胞比值（NLR）对冠心病患者经皮冠状动脉介入治疗（PCI）后临床结局的影响及对预后的预测价值。

方法

回顾性分析6 046例于新疆医科大学第一附属医院心脏中心经冠状动脉造影确诊为冠心病并行PCI治疗的患者临床资料，根据受试者工作特征曲线确定患者NLR的最佳截断值，并据此将患者分为低NLR组（1 997例）、中NLR组（2 025例）和高NLR组（2 024例）。分析各组的一般资料、实验室检查指标及预后结局相关指标，多因素分析影响预后的危险因素。采用

Kaplan-Meier

法分析随访期间患者预后生存情况。

结果

各组患者年龄、心率、男性比例、高血压比例、服用氯吡格雷比例比较差异均有统计学意义(

0.05)，中NLR组和高NLR组上述指标明显高于低NLR组（

0.05）。各组患者NLR、载脂蛋白A1、血糖、尿素氮、肌酐水平比较差异均有统计学意义（

0.05），且中NLR组和高NLR组上述指标明显高于低NLR组（

0.05），高NLR组高于中NLR组（

0.05）。各组患者全因性死亡发生率比较差异具有统计学意义（

0.05），高NLR组全因性死亡发生率明显高于中NLR组及低NLR组（

0.0

）。年龄越大、心率越快、尿素氮越高及服用氯吡格雷是主要不良心脑血管事件（MACCE）发生的独立危险因素(

0.05)。

Kaplan-Meier

生存曲线显示，低NLR组患者的生存率高于中NLR组和高NLR组（

0.001），中NLR组和高NLR组生存率比较差异无统计学意义（

0.05）；

Log-rank

检验显示，低NLR组MACCE发生率明显低于中NLR组及高NLR组（

0.05）。

结论

NLR高、年龄大、心率快、尿素氮高及服用氯吡格雷的冠心病患者PCI后预后较差，其中NLR能够预测冠心病PCI后患者的临床结局。

Abstract

Objective

To investigate the effect of neutrophil to lymphocyte ratio （NLR） on clinical outcomes after percutaneous coronary intervention （PCI） in patients with coronary heart disease and its predictive value on prognosis.

Methods

The clinical data of 6，046 patients with coronary heart disease diagnosed by coronary angiography and treated by PCI in the Heart Center of First Affiliated Hospital of Xinjiang Medical University were analyzed retrospectively.The optimal cutoff value of NLR was determined by the receiver operating characteristic curve，and the patients were divided into the low NLR group （1，997 cases），middle NLR group （2，025 cases） and high NLR group （2，024 cases）. The general data， laboratory examination indexes and prognosis related indexes of each group were analyzed， and the risk factors affecting prognosis were analyzed by multivariate analysis. The survival of patients during follow-up period was analyzed by

Kaplan

Meier

analysis.

Results

There were statistically significant differences in the age，heart rate， and the proportions of men，hypertension，and clopidogrel among groups （

0.05），and the above indexes in the middle NLR group and high NLR group were significantly higher than those in the low NLR group （

0.05）. There were statistically significant differences in the levels of NLR， apolipoprotein A1， blood glucose， urea nitrogen and creatinine among groups （

0.05）， and the above indexes in the middle NLR group and high NLR group were significantly higher than those in the low NLR group （

0.05）， and the high NLR group was higher than the middle NLR group （

0.05）. There was statistically significant difference in the incidence of all-cause death among groups （

0.05）， and the incidence of all-cause mortality in the high NLR group was significantly higher than those in the middle NLR group and the low NLR group （

0.05）.Older age， faster heart rate， higher urea nitrogen， and taking clopidogrel were the independent risk factors for the occurrence of major adverse cardiovascular and cerebrovascular events （MACCE），with statistically significant differences （

0.05）.The

Kaplan

Meier

survival curve showed that the survival rate of patients in the low NLR group was higher than those in the middle NLR group and high NLR group （

0.001），and there was no significant difference in the survival rate between middle NLR group and high NLR group（

0.05）.

Log-rank

test showed that the incidence of MACCE in the low NLR group was significantly lower than those in the middle NLR group and the high NLR group （

0.05）.

Conclusion

Patients with high NLR， old age， fast heart rate， high urea nitrogen and taking clopidogrel have poor prognosis after PCI， among which NLR can predict the clinical outcome after PCI of patients with coronary heart disease.

关键词

经皮冠状动脉介入治疗冠心病中性粒细胞-淋巴细胞比值临床结局冠状动脉造影

Keywords

percutaneous coronary interventioncoronary heart diseaseneutrophil to lymphocyte ratioclinical outcomecoronary angiography

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