摘要
目的:系统评价冠心病(CHD)患者的中性粒细胞与淋巴细胞比值(NLR)与全因死亡风险和不良心血管事件(MACE)发生风险的关系,为冠心病患者的住院及远期预后提供循证医学证据。方法:计算机检索PubMed、EMbase、CNKI、万方和维普等数据库,收集基于国内外人群有关CHD患者的NLR水平与全因死亡率和MACE的预后关系的研究。两例研究员按照纳入和排除标准独立筛选文献、提取数据并进行文献质量评价,采用R3.5.1软件进行Meta分析。结果汇总为优势比(ORS),并显示相应的95%CI。结果:共纳入24篇文献,共计16401例。与低NLR组相比,CHD患者入院时高NLR组总体死亡率高(OR=4.53,95%CI:3.19~6.43,P<0.001),院内死亡率高(OR=4.14,95%CI:3.20~5.37,P<0.001),远期死亡率高(OR=4.97,95%CI:3.25~7.61,P<0.001);高NLR组MACE风险增加(OR=3.52,95%CI:2.53~4.89,P<0.001),高NLR患者PCI后死亡风险显著增加(OR=3.49,95%CI:2.38~5.13,P<0.001)。结论:入院时高NLR是冠心病患者住院期间和长期预后的危险因素,NLR对冠心病患者住院期间及长期预后具有预测价值。
Objective: To systematically evaluate the relationship between neutrophil and lymphocyte ratio ( NLR) and risk of all-cause mortality and adverse cardiovascular events ( MACE) in CHD patients,providing evidence-based medical evidence for the hospitalization and long-term prognosis of CHD patients. Methods: Computers searched PubMed,EMbase,CNKI,Wanfang,and VIP to collect data on the relationship between NLR levels and all-cause MACE in CHD patients based on domestic and international populations. Two researchers independently screened the literature according to inclusion and exclusion criteria,extracted data and performed literature quality evaluation,and performed meta-analysis using R3. 5. 1 software. The result are summarized as odds ratios ( ORS) and show the corresponding 95%CI. Results: A total of 24 literatures were included,with a total of 16401 cases. Compared with the low NLR group,the overall mortality rate of CHD patients was higher at admission ( OR = 4. 53,95%CI: 3. 19-6. 43,P<0. 001),the hospital mortality rate was higher ( OR= 4. 14,95%CI: 3. 20-5. 37,P<0. 001),and the long-term mortality rate was higher ( OR= 4. 97, 95%CI: 3. 25-7. 61,P<0. 001);The risk of MACE increased in high NLR group ( OR= 3. 52,95% CI: 2. 53- 4. 89,P< 0. 001),the mortality risk of patients with high NLR was significantly increased after PCI ( OR = 3. 49,95% CI: 2. 38-5. 13,P<0. 001). Conclusions: High NLR on admission is a risk factor for the hospitalization and long-term prognosis of CHD patients,and NLR has predictive value for the hospitalization and long- term prognosis of CHD patients.
作者
张朝义
刘泽森
孟康
ZHANG Chaoyi;LIU Zesen;MENG Kang(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Iustituce of Heart,Lung and Blood Vessed Piseases,Beijing 100029,China)
出处
《心肺血管病杂志》
2019年第7期773-780,798,共9页
Journal of Cardiovascular and Pulmonary Diseases
