摘要
目的:探讨中性粒细胞与淋巴细胞计数比值(NLR)对行经皮冠脉介入治疗(PCI)的急性冠脉综合征(ACS)患者主要不良心血管事件(MACE)的预测价值。方法:选择在我院行PCI的ACS患者125例,根据GRACE评分(GRS)患者被分为低危组(GRS≤108分,38例)、中危组(109分≤GRS≤140分,46例)、高危组(GRS>140分,41例)。比较不同危险分层组血清C反应蛋白(CRP)、心肌肌钙蛋白T(cTnT)和血浆N末端脑钠肽前体(NT-proBNP)水平及NLR值。根据住院期间和出院后1年内MACE发生情况,患者被分为MACE组(94例)和非MACE组(31例),比较两组GRS、NLR值及CRP水平。采用ROC曲线评价NLR对患者MACE的预测价值。结果:随着ACS的危险分层的上升,NLR值[1.80(0.76)比2.68(1.33)比3.82(3.25)]显著升高(P均=0.001)。与非MACE组比较,MACE组GRS[114.0(37.5)分比162.0(52.0)分]、NLR值[2.4(1.5)比3.9(4.8)]和CRP[3.5(6.9)mg/L比12.2(40.8)mg/L]水平均显著升高(P均=0.001)。ROC曲线分析NLR、GRS、GRS+NLR对发生MACE的预测价值,其曲线下面积(AUC)分别为:0.810(95%CI:0.722~0.897)、0.837(95%CI:0.756~0.917)、0.849(95%CI:0.774~0.925)。结论:NLR作为一项简便易获取的常规检验指标,联合GRACE评分可更加准确地预测PCI术后ACS患者的预后,具有重要临床价值。
Objective:To explore predictive value of neutrophil/lymphocyte(NLR)for major adverse cardiovascular events(MACE)in patients with acute coronary syndrome(ACS)undergoing percutaneous coronary intervention(PCI).Methods:A total of 125 ACS patients undergoing PCI in our hospital were selected.According to GRACE risk score(GRS),patients were divided into low risk group(GRS≤108 scores,n=38),medium risk group(109 scores≤GRS≤140 scores,n=46)and high risk group(GRS>140 scores,n=41).Levels of serum C reactive protein(CRP),cardiac troponin T(cTnT),plasma N terminal pro brain natriuretic peptide(NT-proBNP)and NLR were compared among different risk stratification group.According to incidence of MACE during hospitalization and within one year after discharge,patients were divided into MACE group(n=94)and non-MACE group(n=31),then GRS score,NLR and CRP level were compared between them.ROC curve was used to assess predictive value of NLR for MACE.Results:Along with risk stratification of ACS rose,there was significant rise in NLR[1.80(0.76)vs.2.68(1.33)vs.3.82(3.25)],P=0.001 all.Compared with non-MACE group,there were significant rise in GRS[114.0(37.5)scores vs.162.0(52.0)scores],NLR[2.4(1.5)vs.3.9(4.8)]and CRP level[3.5(6.9)mg/L vs.12.2(40.8)mg/L]in MACE group,P=0.001 all.ROC curve analysis indicated that area under the curve(AUC)of NLR,GRS and GRS+NLR was 0.810(95%CI:0.722~0.897),0.837(95%CI:0.756~0.917)and 0.849(95%CI:0.774~0.925)respectively in predicting MACE.Conclusion:As an simple and available routine index,NLR can more accurately predict prognosis of ACS patients after PCI when combined with GRACE score,which possesses important clinical value.
作者
占凌辉
侯炳波
路丹
黄森
赵亚男
刘岁丰
郭峰
高峰
ZHAN Ling-hui;HOU Bing-bo;LU Dan;HUANG Sen;ZHAO Ya-nan;LIU Sui-feng;GUO Feng;GAO Feng(Department of Critical Medicine,Affiliated Zhongshan Hospital of Xiamen University,Xiamen,Fujian,361004,China)
出处
《心血管康复医学杂志》
CAS
2020年第2期146-150,共5页
Chinese Journal of Cardiovascular Rehabilitation Medicine
