摘要
背景目前心力衰竭患者的死亡率仍然很高,且国内外关于中性粒细胞与淋巴细胞比值与心力衰竭患者5年全因死亡的相关性临床研究较为缺乏。目的分析心力衰竭患者中性粒细胞与淋巴细胞比值与5年全因死亡的关系。方法本研究为单中心回顾性研究,选取2012年8月—2013年7月于广西医科大学第一附属医院住院的成年症状性心力衰竭〔纽约心脏病协会(NYHA)心功能分级Ⅲ~Ⅳ级〕患者418例为研究对象,收集患者的临床资料并电话随访了解心力衰竭患者的5年全因死亡情况。根据患者中性粒细胞与淋巴细胞比值等分为4组,分析中性粒细胞与淋巴细胞比值与心力衰竭患者5年全因死亡率的关系。结果本研究心力衰竭患者全因死亡率为55.3%(231/418)。单因素分析结果显示,尿素、肌酐、胱抑素C、肌酸激酶同工酶、N末端B型利钠肽前体、心功能分级、中性粒细胞与淋巴细胞比值高是心力衰竭患者5年全因死亡的危险因素(P<0.05),而体质量高、三酰甘油水平高、使用β-受体阻滞剂是心力衰竭患者5年全因死亡的保护因素(P<0.05),女性心力衰竭患者5年全因死亡发生风险低于男性(P<0.05)。在校正了多种混杂因素后,中性粒细胞与淋巴细胞比值仍然是心力衰竭患者5年全因死亡的独立预测因素(P<0.05)。结论中性粒细胞与淋巴细胞比值是心力衰竭患者5年全因死亡的独立预测因素,比值越高,风险越大。
Background The mortality rate of heart failure(HF)remains high.And there are limited clinical studies on the relationship between neutrophil-to-lymphocyte ratio(NLR)and 5-year all-cause mortality in such patients.Objective To investigate the correlation between NLR and 5-year all-cause mortality in patients with HF.Methods This study was a single-center retrospective study.418 adult patients with symptomatic HF(NYHA classⅢ-Ⅳ)hospitalized in the First Affiliated Hospital of Guangxi Medical University from August,2012 to July,2013 were enrolled.Clinical data and telephonebased follow-up results were collected to understand the 5-year all-cause mortality.The relationship between NLR and 5-year allcause mortality was analyzed across quartile subgroups stratified by NLR value.Results The 5-year all-cause mortality in the participants was 55.3%(231/418).Univariate analysis showed that urea,creatinine,cystatin C,creatine kinase isozyme,plasma N-terminal B-type natriuretic peptide precursor,higher NYHA classes,and elevated NLR increased the risk of 5-year all-cause mortality in HF patients(P<0.05),whereas high weight and triglyceride,the use ofβreceptor blockers,and women decreased the risk(P<0.05).After adjusting for other covariates,NLR remained an independent predictor of 5-year all-cause mortality(P<0.05).Conclusion NLR is an independent predictor of 5-year all-cause mortality in HF patients.The higher the ratio,the higher the risk.
作者
罗发新
叶自亮
朱继金
LUO Faxin;YE Ziliang;ZHU Jijin(Department of Emergency,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Cardiology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)
出处
《中国全科医学》
CAS
北大核心
2019年第34期4213-4219,共7页
Chinese General Practice
