中性粒细泡/淋巴细胞比值对急性心肌梗死合并多支血管病变病人预后的预测

    Prediction of neutrophil to lymphocyte ratio on prognosis of patients with acute myocardial infarction combined with multi-vessel disease

    • 摘要:
      目的探讨中性粒细泡/淋巴细胞比值(NLR)对急性心肌梗死(AMI)合并多支血管病变(MVD)病人预后的预测价值。
      方法纳入216例临床资料完整的AMI合并MVD病人,根据ROC曲线确定NLR预测2年全因死亡的截点值,将病人分为高NLR组60例,低NLR组156例,通过Cox回归分析AMI合并MVD病人的NLR对其远期预后的预测作用。
      结果ROC曲线结果得出NLR预测2年全因死亡的截点值为3.65。高NLR组病人年龄、高血压患病率、白细胞计数、中性粒细胞计数及高敏C反应蛋白含量均高于低NLR组(P < 0.05~P < 0.01),淋巴细胞计数低于低NLR组(P < 0.01)。多因素COX回归分析结果显示,NLR、高血压及中性粒细胞计数为影响AMI合并MVD病人全因死亡的独立危险因素(P < 0.05~P < 0.01),NLR和中性粒细胞计数为影响病人MACCE发生的独立影响因素(P < 0.05和P < 0.01)。
      结论NLR预测2年全因死亡的截点值为3.65,NLR是影响AMI合并MVD病人预后的独立因素。

       

      Abstract:
      ObjectiveTo analyze the predictive value of neutrophil to lymphocyte ratio(NLR) on prognosis of patients with acute myocardial infarction(AMI) combined multi-vessel disease(MVD).
      MethodsA total of 216 cases of AMI combined with MVD with complete clinical data were included.Patients were divided into high NLR group(60 cases) and low NLR group(156 cases) according to the optimal cut-off value of admission NLR to predict 2-year all-cause mortality.The predictive effect of NLR on the long-term prognosis of AMI patients combined with MVD was analyzed by Cox regression analysis.
      ResultsThe results of ROC curve showed that the cut-off point value of 2-year all-cause mortality predicted by NLR was 3.65.Compared with patients in the low NLR group, patients in the high NLR group were older and had a higher incidence of hypertension(P < 0.05), and the white blood cell count, neutrophil count and high sensitivity C reactive protein were higher, and the lymphocyte count was lower(P < 0.01).The results of multivariate Cox risk regression analysis showed that NLR, hypertension and neutrophil count were the independent factors affecting all-cause mortality in AMI patients combined with MVD(P < 0.05 to P < 0.01), and NLR and neutrophil count were independent factors affecting the occurrence of MACCE(P < 0.05 and P < 0.01).
      ConclusionsThe cut-off point value of NLR predicting 2-year all-cause mortality is 3.65.NLR is an independent factor affecting the prognosis of AMI patients combined with MVD.

       

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