河北医科大学学报

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中性粒细胞淋巴细胞比值与急性冠状动脉综合征患者左心室收缩功能不全的相关性分析

  

  1. 1.北京市利康医院住院部,北京 102609;2.中国康复研究中心北京博爱医院心内科,北京 100068;
    3.首都医科大学附属北京安贞医院急诊科,北京 100029;4首都医科大学宣武医院心脏科,北京 100053
  • 出版日期:2016-09-25 发布日期:2016-09-28
  • 作者简介:刘建峰( 1978- ),河北滦县人,北京市利康医院主治医师,医学硕士,从事心血管内科疾病诊治研究。
  • 基金资助:
    国家高科技发展计划( 863计划)资助项目( 2012AA02A516 )

  1. 1.Department of Inpatient, Beijing Likang Hospital, Beijing 102609, China; 2.Department of Cardiology,
    Beijing Boai Hospital, China Rehabilitation Research Centre, Bejing 100068, China; 3.Department of
    Emergency, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China;
    4. Department of Cardiology, Xuanwu Hospital,Capital Medical University, Beijing 100058, China
  • Online:2016-09-25 Published:2016-09-28

摘要: [摘要] 目的 探讨中性粒细胞/淋巴细胞比值( neutrophil-lymphocyteratio , NLR )与急性冠状动脉综合征
(
acutecoronarysyndrome , ACS )患者左心室收缩功能的相关性。方法 回顾性分析 438 例 ACS 患者的临床资料。
入选者均于入院后、冠状动脉造影和药物应用之前从肘静脉抽血,查血常规并计算求得 NLR 。所有患者于入院 72
h 内心脏彩超检查测得左心室射血分数( leftventricularejectionfraction , LVEF ),根据 LVEF 将 ACS 患者分为 2
组:左心室收缩功能不全组( LVEF<50% )
81 例和左心室收缩功能正常组( LVEF≥50% ) 357 例。结果 ① 与左心
室收缩功能正常组比较,左心室收缩功能不全组年龄、 hsCRP 、 WBC 计数以及 NLR 水平明显偏高,差异均有统计
学意义( P <0.05 );左心室收缩功能不全组的 AMI 患病率较高,再灌注治疗的比率偏低(
P <0.05 )。 ②Pearson 相
关性分析显示 ACS 患者的 NLR 与 LVEF 值呈显著负相关( r =-0.
582 , P <0.01 )。 ③ 多因素 Logistic 回归分析
结果显示,在校正了年龄、
hsCRP 、冠状动脉介入/冠状动脉搭桥治疗等因素后, NLR 仍是 ACS 患者左心室收缩功
能不全的独立危险因素( OR =1.398 , 95% CI =1.
151~1.696 , P =0.001 )。结论 ACS 患者发病早期的 NLR 与
LVEF 呈显著负相关。 NLR 可作为非 ST 段抬高型 ACS 患者近期左心室收缩功能不全的独立危险因素。

关键词: 急性冠状动脉综合征, 每搏输出量, 心室功能障碍,

Abstract: [ Abstract ] Objective Tostudythecorrelationofneutrophil-lymphocyteratio ( NLR ) andthe
leftventricularsystolicfunctioninpatientswithacutecoronarysyndrome ( ACS ) .Methods A
totalof438 cases with ACS wereincludedinthestudy.The NLR was obtained before
endovascularreperfusiontherapyandmedicationtreatment.Allofthepatientswereexaminedby
echocardiographywithin72 hoursafteradmissionandobtainedtheleftventricularejection
fraction ( LVEF ) .Thestudypopulationwasincludedintoleftventricularsystolicfunctiongroup
(
LVEF<50% ) andnon-leftventricularsystolicfunction ( LVEF≥50% ) .Results ①Compared
withnon-leftventricularsystolicfunctiongroup , theage , hsCRP , WBCcountandNLRlevels wereobviouslyhigherinthepatientswithleftventricularsystolicfunction , thedifferencewas
statisticallysignificant ( P <0.05 ) .AMIprevalencewashigherandtheratioofreperfusionwas
lowinleftventricularsystolicfunctiongroupthanthatinnon-leftventricularsystolicfunction
group ( P <0.05 ) .② Pearsoncorrelationanalysisshowedthat NLR and LVEF valuehad
significantnegativecorrelationinpatientswithACS ( r =-0. 582 , P <0.01 ) .③Themultivariate
LogisticregressionanalysisshowedthatNLRwasanindependentriskfactorforthedevelopment
ofleftventricularsystolicfunctioninpatientswithACSafteradjustedforage , thehsCRP , AMI
andPCI / CABG reperfusiontherapy ( OR =1.398 , 95% CI =1.151-1.696 , P =0.001 ) .
Conclusion NLRandLVEFwassignificantlynegativecorrelationinpatientswithACS.NLR
canbeusedasindepen

Key words: acutecoronarysyndrome , strokevolume , ventriculardysfunction, left