中性粒细胞与淋巴细胞比值同非ST段抬高型急性冠状动脉综合征病人左室收缩功能不全的关系探讨

摘要

Objective To explore the relationship between neutrophil-lymphocyte ratio (NLR) and left ventricular systolic dysfunction in patients with non ST-elevated acute coronary syndrome (NSTE-ACS).Methods A total of 200 patients with NSTE-ACS were included in the study.The study population was divided into low,medium and high groups based on admission NLR values.And then the relationship between neutrophil-lymphocyte ratio and left ventricular systolic dysfunction was studied.Results The patients in the high NLR group were older (P=0.003),with higher rate of diabetes mellitus and non-ST elevated myocardial infarction (NSTEMI) (P=0.015,P=0.011) and lower left ventricular ejection fraction (LVEF) (P<0.001).Baseline WBC (P=0.005) and neutrophil (P<0.001) levels and NLR (P<0.001) were significantly higher,and lymphocyte (P<0.001) levels were significantly lower in the high NLR group.NLR was negatively correlated with LVEF in Pearson correlation analysis.Results of receiver operating characteristic cure showed the accuracy and effectiveness of NLR in detecting LVSD in patients with NSTE-ACS.An NLR ≥2.73 was found to be an independent predictor of systolic dysfunction in patients with non ST-elevated acute coronary syndrome in univariate and multivariate logstic regression analyses after adjusting other risk factors.Conclusion The NLR is an independent predictor for LVSD in patients with NSTE-ACS.%目的 探讨中性粒细胞与淋巴细胞比值(NLR)同非ST段抬高型急性冠状动脉综合征(NSTE-ACS)病人左室收缩功能不全(LVSD)的关系.方法 200例NSTE-ACS病人纳入该项研究,根据入院时的NLR值分为低水平、中水平、高水平三组,分析NLR水平与NSTE-ACS病人LVSD的关系.结果 高水平NLR组病人年龄较大(P=0.003)、糖尿病及非ST段抬高型心肌梗死(NSTEMI)病人较多(P=0.015,P=0.011)、左室射血分数(LVEF)较低(P<0.001),白细胞数、中性粒细胞数及NLR偏高(P=0.005,P<0.001,P<0.001),淋巴细胞数偏低(P<0.001),差异有统计学意义.在Pearson线性相关分析中,NLR与NSTE-ACS病人LVEF呈负相关.受试者工作特征曲线(ROC曲线)结果显示NLR对NSTE-ACS病人LVSD有诊断价值.在单因素及多因素Logistic回归分析中,NLR≥2.73是校正其他危险因素后NSTE-ACS病人LVSD的独立预测因子.结论 NLR是NSTE-ACS病人左室收缩功能不全的独立预测因子.