摘要
目的探讨中性粒细胞与淋巴细胞比值(NLR)与经皮冠状动脉介入治疗(PCI)术后老年ST段抬高型心肌梗死(STEMI)患者远期预后的关系。方法作为回顾性队列研究,连续纳入2017年1月至12月在华北石油总医院行经皮冠状动脉介入治疗(PCI)的老年STEMI患者276例,根据X-tile软件确定NLR预测720 d发生主要不良心血管事件(MACE)的最佳临界值,分为高NLR组和低NLR组。临床终点为MACE。结果通过X-tile 3.6.1软件测算显示NLR预测720 d发生MACE的临界值6.4。纳入的276例患者中,51例(18.5%)NLR≥6.4,归为高NLR组,225例(81.5%)例NLR<6.4,归为低NLR组。高NLR组患者糖尿病、吸烟比例明显高于低NLR组(P均<0.05)。就诊时间方面,2组有明显不同(P<0.05)。随访结果显示,高NLR组患者28例(54.9%)、低NLR组患者36例(16.0%)发生MACE,差异有统计学意义(P<0.001)。Cox多因素回归分析结果显示,NLR≥6.4是老年急性ST段抬高型心肌梗死MACE(HR=3.410,95%CI 2.004~5.802,P<0.001)的独立预测因子。结论NLR是老年STEMI患者远期MACE的独立预测因子,具有较强的预测价值。
Objective To explore the relationship between neutrophil-to-lymphocyte ratio(NLR)and the long-term prognosis of elderly patients with ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods The clinical data of elderly STEMI patients(n=276),who were hospitalized at General Hospital of Huabei Oil Field from Jan.2017 to Dec.2017,were retrospectively analyzed.The best cut-off value of NLR was determined by the X-tile software.Patients were divided into 2 sub-groups based on the cut-off value of NLR to predict 720-day major adverse cardiovascular events(MACE).The endpoint was MACE.Results By using X-tile 3.6.1 software,the optimal cut-off point of NLR to predict 720-day MACE was 6.4.The 276 patients were divided into high-NLR group(n=51,15.5%)and low NLR group(n=225,81.5%).The high NLR group had higher prevalence of diabetes and smoking(P<0.05).There were significant differences in the time of visit between the two groups(P<0.05).During the follow-up period,rate of MACE was significantly higher in the high NLR group than in the low NLR group[54.9%(28/51)vs 16.0%(36/225),P<0.001].Multivariate Cox regression analysis showed that NLR≥6.4 was determined as an independent predictor of MACE(HR=3.410,95%CI 2.004-5.802,P<0.001)in elderly STEMI patients.Conclusion NLR is an independent predictor of long term MACE in elderly STEMI patients,which is of ligh predictire value.
作者
王海斌
高晓丽
谢明
张小坤
于成娟
李伟华
王丽丽
WANG Hai-bin;GAO Xiao-li;XIE Ming;ZHANG Xiao-kun;YU Cheng-juan;LI Wei-hua;WANG Li-li(Department of Cardiology,General Hospital of Huabei Oil Field Affiliated to Hebei Medical University,Renqiu,062552,China)
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2022年第2期146-150,共5页
Chinese Journal of Practical Internal Medicine
基金
河北省科技厅科研项目(182777198)。
关键词
老年
急性心肌梗死
中性粒细胞与淋巴细胞比值
预后
elderly patients
acute myocardial infarction
neutrophil to lymphocyte ratio
prognosis
