摘要
目的探讨急性心肌梗死后中性粒细胞与淋巴细胞比率(NLR)、外周血管疾病、年龄和血清肌酐(NPAC)评分与生存率的相关性。方法回顾性分析2014年1月至2020年1月于铁岭市中心医院心血管内科住院并诊断为急性心肌梗死的患者457例(心肌梗死组)。另选取我院同期体检正常的健康者400例为对照组。将两组患者的年龄、性别、体质指数(BMI)、吸烟、高血压、高密度脂蛋白胆固醇(HDL-C)、丙氨酸氨基转移酶(ALT)、纤维蛋白原(FBG)、外周血管疾病、收缩压、舒张压、空腹血糖(FPG)、C反应蛋白(CRP)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)和NLR进行对比分析,通过Logistic回归分析急性心肌梗死后生存率的影响因素,采用Kaplan-Meier方法分析NPAC评分与生存率的相关性。结果急性心肌梗死组中的收缩压、舒张压、FPG、CRP、LDL-C、TG和TC明显高于对照组,差异有统计学意义(P<0.05);急性心肌梗死组中的BNP、肌酐、肌钙蛋白I(cTnI)明显低于对照组,差异有统计学意义(P<0.05);NLR<9.51和NLR≥9.51中的年龄、ST段抬高型心肌梗死(STEMI)、非ST段抬高型心肌梗死(NSTEMI)、NPAC评分、外周血管疾病和肌酐差异有统计学意义(P<0.05);NLR≥9.51与非住院死亡率(OR=3.455,95%CI:2.421~4.959,P<0.001)、30 d死亡率(OR=2.749,95%CI:1.956~3.864,P<0.001)和90 d死亡率(OR=3.186,95%CI:2.422~4.413,P<0.001)相关。年龄≥65岁(OR=3.671,95%CI:2.623~5.164,P<0.001)、外周血管疾病(OR=3.042,95%CI:1.536~6.037,P=0.002)、高NLR(OR=2.725,95%CI:2.136~3.538,P<0.001)、肌酐(OR=2.974,95%CI:2.365~3.864,P<0.001)、高NLR住院死亡率(OR=2.96,95%CI:2.26~3.89,P<0.001)、30 d死亡率(OR=2.43,95%CI:1.86~3.17,P<0.001)和90 d死亡率(OR=2.73,95%CI:2.12~3.51,P<0.001)是NPAC评分的独立危险因素;NPAC评分≤4的患者90 d死亡风险增加11.83%,NPAC评分≥5的患者90 d死亡风险增加36.98%,差异有统计学意义(P<0.05)。结论NPAC评分将为急性心
Objective To investigate the correlation between neutrophils to lymphocytes ratio(NLP)-peripheral vascular disease-age-creatinine(NPAC)scores and survival rate after acute myocardial infarction(AMI).Methods AMI patients(n=457,AMI group)and healthy controls(n=400,control group)were chosen from Department of Cardiovascular Medicine in Central Hospital of Tieling City from Jan.2014 to Jan.2020.Age,sex,body mass index(BMI),smoking,hypertension,high-density lipoprotein-cholesterol(HDL-C),alamine aminotransferase(ALT),fibrinogen(FBG),peripheral vascular disease,systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),C-reactive protein(CRP),low-density lipoprotein-cholesterol(LDL-C),triglyceride(TG),total cholesterol(TC)and NLR were compared and analyzed in 2 groups.The influence factors of survival rate after AMI were analyzed by using Logistic regression analysis,and correlation between NPAC scores and survival rate was analyzed by using Kaplan-Meier method.Results SBP,DBP,FPG,CRP,LDL-C,TG and TC were significantly higher in AMI group than those in control group(P<0.05).BNP,creatinine(Cr)and cTnI were significantly lower in AMI group than those in control group(P<0.05).The difference in age,STEMI,NSTEMI,NPAC scores,peripheral vascular disease and Cr had statistical significance between patients with NLR<9.51 and those with NLR≥9.51(P<0.05).NLR≥9.51 was correlated to non-nosocomial mortality(OR=3.455,95%CI:2.421~4.959,P<0.001),30-d mortality(OR=2.749,95%CI:1.956~3.864,P<0.001)and 90-d mortality(OR=3.186,95%CI:2.422~4.413,P<0.001).Ag≥65(OR=3.671,95%CI:2.623~5.164,P<0.001),peripheral vascular disease(OR=3.042,95%CI:1.536~6.037,P=0.002),high NLR(OR=2.725,95%CI:2.136~3.538,P<0.001),Cr(OR=2.974,95%CI:2.365~3.864,P<0.001),high NLR nosocomial mortality(OR=2.96,95%CI:2.26~3.89,P<0.001),30-d mortality(OR=2.43,95%CI:1.86~3.17,P<0.001)and 90-d mortality(OR=2.73,95%CI:2.12~3.51,P<0.001)were independent risk factors of NPAC scores.The risk of 90-d mortality increased by 11.83%in patients with NP
作者
徐子文
王俏
李洪凤
郑可欣
王晶
Xu Ziwen;Wang Qiao;Li Hongfeng;Zheng Kexin;Wang Jing(Department of Intensive Medicine,Central Hospital of Tieling City,Tieling 112000,China;不详)
出处
《中国循证心血管医学杂志》
2021年第3期349-353,共5页
Chinese Journal of Evidence-Based Cardiovascular Medicine
