摘要
目的探讨入院时中性粒细胞/淋巴细胞比率(NLR)预测急性冠状动脉综合征(ACS)患者住院及长期死亡率的价值。方法连续收集2008年7月至2010年12月入住我院心脏中心CCU的1534例ACS患者的临床资料,选择符合入选标准的1022例患者进行随访,共899例患者完成了随访。根据入院即刻的血常规结果,按NLR大小将患者分为低、中、高值3组,对3组ACS患者的住院及长期死亡率进行比较。结果随着NLR增高,患者的男性比例(χ2=6.497)、患高血压(χ2=12.577)和糖尿病的比例(χ2=9.744)、有冠心病家族史的比例(χ2=10.396)等均明显增加(均为P<0.05),而吸烟者比例则明显减少(χ2=6.506,P<0.05)。住院及随访期间共死亡患者132例,与低值组比较,高值组患者住院死亡率明显升高(8.5%比2.4%,χ2=37.765,P<0.001)。COX回归分析表明,NLR是住院及随访期间死亡率重要的预测因子,与低值组比较,高值组患者住院期间死亡危险比为2.13(95%CI:1.37～3.98,P=0.02),随访期间死亡危险比为2.88(95%CI:1.71～6.06,P<0.001)。结论入院时NLR是与ACS患者住院及随访期间死亡密切相关的独立危险因素。
Objective To investigate the utility of admission neutrophil/lymphoeyte ratio （NLR） in predicting in-hospital and long-term mortality in patients with acute coronary syndrome （ACS）. Methods We analyzed 1534 consecutive patients admitted with ACS to a single university hospital center. White blood cells （WBC） and differential count were measured at admission. Patients with cancer, inflammatory diseases, or premature death were excluded, and 1022 patients were included in the final analysis. Patients were divided into tertiles according to NLR. The primary end point was all-cause in-hospital and 2-year mortality. Results Most cardiovascular risk factors were significantly higher in the third - tertile population compared to those in the lower tertiles. But patients in the highest tertile of NLR had a lowest proportion of current smokers. There were a total of 132 deaths （ 14. 7% ） during a mean 2-year follow-up. Patients in the highest tert^le had higher in-hospital mortality rate compared with those in the lowest tertile （ 8.5% vs. 2.4% , X~ = 37. 765, P 〈 0. 001 ）. After adjusting for standard risk factors, patients in the highest tertile were at an exaggerated risk for in-hospital （hazard ratio 2. 13, 95% CI： 1.37-3.98, P = 0. 02） and 2-year （ hazard ratio 2. 88, 95% C1.. 1.71-6. 06, P 〈 0. 001 ） mortality. Conclusions Admission NLR is an independent predictor of in-hospital and 2-year mortality in patients with ACS.
出处
《中国心血管杂志》
2013年第3期177-181,共5页
Chinese Journal of Cardiovascular Medicine
