广州医药 ›› 2018, Vol. 49 ›› Issue (5): 13-17.DOI: 10.3969/j.issn.1000-8535.2018.05.004

• 论著 • 上一篇    下一篇

入院首次中性粒细胞/淋巴细胞比值与急性心肌梗死患者院内主要不良心血管事件发生的相关性研究

叶飘, 雷晓明   

  1. 广州市第一人民医院心血管内科(广州 510180)
  • 收稿日期:2018-05-11 出版日期:2018-09-20 发布日期:2021-11-29

The correlation between neutrophil/lymphocyte ratio and in-hospital major adverse cardiac events in patients with acute myocardial infraction at the early admission

YE Piao, LEI Xiaoming   

  1. Department of Cardiology, Guangzhou First People's Hospital,Guangzhou 510180,China
  • Received:2018-05-11 Online:2018-09-20 Published:2021-11-29

摘要: 目的 探讨急性心肌梗死患者入院首次中心粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)与院内主要不良心血管事件(MACE)发生的相关性。方法 回顾分析2016年1月—2016年12月入住我院的急性心肌梗死患者179例,分为发生院内不良事件组(n=46)和未发生组(n=133)。采用单因素及多因素Logistics回归分析评估NLR与MACE风险的相关性。结果 179例患者中,46例患者发生院内MACE。发生院内MACE组患者的淋巴细胞计数低于未发生组(P<0.05),NLR高于未发生组(P<0.05),发生院内MACE组患者入院时的心、肾功能较未发生组差(P<0.05)。单因素回归分析显示,NLR水平与院内MACE发病率相关(OR=1.079,95%CI:1.014~1.147, P<0.05)。多因素logistic回归分析校正性别、年龄、高血压病史、糖尿病史、Killip II级以上、收缩压、入院首次白细胞、eGFR、超敏C反应蛋白、左室射血分数及多支病变后显示,NLR是院内MACE的独立危险因素(OR=1.182,95%CI:1.034~1.352,P<0.05);此外,超敏C反应蛋白及LVEF<50也是院内MACE的独立危险因素(P<0.05)。结论 入院首次高NLR与急性心肌梗死患者发生院内MACE相关,是患者发生院内MACE的独立危险因素。

关键词: 急性心肌梗死, 中性粒细胞/淋巴细胞比值, 院内不良事件

Abstract: Objective To explore the correlation between first neutrophil/lymphocyte ratio(NLR) and in-hospital major adverse cardiac events (MACE) in patients with in patients with acute myocardial infarction. Methods Total of 179 patients with acute myocardial infarction in Guangzhou First People's Hospital from Jan 2016 to Dec 2016 were enrolled. MACE was defined as malignant arrhythmia, recurrence of myocardial infarction, target vascular reconstruction, acute left heart failure, stroke, cardiac shock and death.Baseline data and in-hospital clinical adverse events were compared among two groups. All patients were divided into two groups:MACE(+) group and MACE(-) group. Univariate and multivariate logistic regression was used to assess the correlation between NLR and in-hospital MACE. Results In-hospital MACE occurred in 46(25.7%)patients. Univariate logistic analysis showed that NLR was strongly related with MACE incidence(OR=1.079,95%CI:1.014~1.147, P<0.05). Multivariate logistic regression analysis found that after adjusting other traditional risk factors including female gender, age, hypertension,diabetes, overKillip II grade, systolic blood pressure,first white blood cells after admitted,basic renal dysfunction,Hs-CRP,LVEF and multivessel lesions. NLR was still a significant independent predictor of in-hospital MACE in patients with acute myocardial infarction. Additionally, hs-CRP and LVEF<50% were also associated with in-hospital MACE(P<0.05). Conclusion NLR is the independent risk factor for in-hospital MACE occurrence in acute myocardial infarction at the early admission.

Key words: Acute myocardial infarction, Neutrophil/lymphocyte ratio, Major adverse cardiac events