摘要
目的探讨白细胞(WBC)计数、中性粒细胞与淋巴细胞比值(NLR)对急性ST段抬高型心肌梗死(STEMI)患者短期预后的影响。方法收集2013年10月至2015年12月在首都医科大学宣武医院住院的STEMI患者资料,依据WBC> 10×109/L或≤10×109/L将患者分为WBC升高组和WBC正常组,比较两组患者的临床特点及住院死亡率。多因素回归分析WBC、NLR与STEMI患者住院期间预后的关系。结果 374例患者纳入研究,男性294例,女性80例。与WBC正常组(182例)比较,WBC升高组(192例)患者的平均年龄较低[(60. 4±12. 3)岁比(64. 8±11. 8)岁,P=0. 001],入院时收缩压较低[(130±24) mm Hg比(136±21) mm Hg,P=0. 014],而住院死亡率显著升高(8. 0%比1. 1%,P <0. 01)。多因素分析显示,NLR升高(OR=1. 106,95%CI:1. 015～1. 204,P=0. 021)和WBC升高(OR=1. 289,95%CI:1. 055～1. 576,P=0. 013)是STEMI患者住院死亡率的独立预测因素。结论入院时WBC或NLR升高的STEMI患者短期心血管事件的发生风险显著增加。
Objective To investigate the effects of white blood cell count and neutrophil-tolymphocyte ratio(NLR)on the short-term prognosis of patients with ST-segment elevation myocardial infarction(STEMI). Methods The cases of STEMI were collected in Xuanwu Hospital Capital Medical University from October 2013 to December 2015.The patients were divided into 2 groups according to leukocyte count(WBC elevated group WBC>10×109/L or WBC normal group WBC≤10×109/L).The clinical characteristics and hospital mortality were compared between the two groups.The relationship between WBC,NLR and the in-hospital prognosis were analyzed by multivariate regression analysis.Resultes A total of 374 cases were enrolled in the study(Male 294,Female 80).The mean age of the elevated WBC count group(192 patients)is lower than that of the normal WBC count group(182 patients)[(60.4±12.3)years old vs.(64.8±11.8)years old,P=0.001];The admission systolic pressure of the elevated WBC count group was statistically lower than that of the normal group[(130±24)mmHg vs.(136±21)mmHg,P=0.014].The mortality rate of elevated WBC count group was significantly increased(8.0%and 1.1%,P=0.002).The analysis of logistic regression indicated that the elevated WBC count(OR=1.289,95%Cl:1.055-1.576,P=0.013)and NLR(OR=1.106,95%Cl:1.015-1.204,P=0.021)were independent predictors of the in-hospital fatality rate for patients with acute STEMI.Conclusions The elevated WBC count or NLR predicts higher mortality rate of in-hospital patients with STEMI at admission.
作者
刘马超
杭莺
刘云
费甄甄
Liu Machao;Hang Ying;Liu Yun;Fei Zhenzhen(Department of Cardiology,Affiliated Xuanwu Hospital of Capital Medical University,Beijing 100053,China)
出处
《中国心血管杂志》
2018年第5期384-388,共5页
Chinese Journal of Cardiovascular Medicine
