摘要
目的 探讨外周血中性粒细胞计数与老年高血压人群心肌梗死、脑梗死、脑出血以及全因死亡的关系。方法 纳入开滦2006年1月—2009年12月研究人群9 218例老年高血压患者,分别以心肌梗死、脑梗死、脑出血及全因死亡为次要终点,以次要终点构成的复合终点为主要终点,采取前瞻性队列研究方法,依据观察对象中性粒细胞计数(×10~9/L)四分位分组,Q1组(中性粒细胞计数<3.1)、Q2组(3.1≤中性粒细胞计数<3.7)、Q3组(3.7≤中性细胞计数<4.6)及Q4组(中性粒细胞计数≥4.6),用寿命表方法统计各组各终点事件累积发生率,采用Cox比例风险模型分析方法,探讨中性粒细胞计数对各终点事件的影响。结果 在(9.3±2.7)年的随访时间内,共发生心肌梗死350例、脑梗死843例、脑出血174例、全因死亡3 119例、共有复合终点3 828例。以Q1组为对照,多因素Cox比例风险回归模型分析显示Q2组、Q3组和Q4各组发生心肌梗死HR值(95%CI)分别为1.15(0.81~1.63)、1.41(1.02~1.95)、1.28(0.91~1.80);脑梗死HR值(95%CI)分别为1.41(1.14~1.74)、1.24(1.00~1.53)、1.37(1.10~1.70);脑出血HR值(95%CI)分别为1.51(0.95~2.41)、1.62(1.03~2.55)、1.05(0.62~1.76);全因死亡HR值(95%CI)分别为1.09(0.97~1.21)、1.21(1.09~1.35)、1.37(1.23~1.52);复合终点HR值(95%CI)分别为1.18(1.06~1.30)、1.26(1.14~1.38)、1.40(1.27~1.54)。结论 在老年高血压人群中,中性粒细胞计数与脑梗死、全因死亡以及复合终点事件风险呈正相关,而心肌梗死、脑出血风险则在Q3组3.7≤中性粒细胞计数<4.6×10~9/L最高。这提示中性粒细胞计数可能成为评估老年高血压患者心脑血管事件及全因死亡的潜在生物学标志物。
Objective To investigate the association of peripheral blood neutrophil count with myocardial infarction,cerebral infarction,cerebral hemorrhage and all-cause mortality among elderly hypertensive population.Methods In this prospective cohort study,9281 elderly hypertensive patients from Kailuan from January 2006 to December 2009 study cohort were included,and followed up with the incidence of primary endpoints(composite endpoints consisting of myocardial infarction,cerebral infarction,cerebral hemorrhag,and all-cause death)and the incidence of secondary endpoints(myocardial infarction,cerebral infarction,cerebral hemorrhag,and all-cause death).Patients were categorized into four groups on the basis of quartile of neutrophil count(×109/L):Q1(neutrophil count<3.1),Q2(3.1≤neutrophil count<3.7),Q3(3.7≤neutrophil count<4.6),and Q4(neutrophil count≥4.6).The life table method was used to calculate the cumulative incidence of each endpoint event in each group,and the Cox proportional hazards model was used to evaluate the impact of neutrophil count on each endpoint event.Results During an average of(9.3±2.7)years of follow-up,there were 350 cases of myocardial infarction,843 cases of cerebral infarction,174 cases of cerebral hemorrhage,3,119 cases of all-cause mortality,and a total of 3,828 cases of the composite endpoint.Using the Q1 group as the reference,the multivariate Cox proportional hazards regression model analysis showed that the HRs(95%CI)for myocardial infarction in the Q2,Q3,and Q4 groups were 1.15(0.81-1.63),1.41(1.02―1.95),and 1.28(0.91―1.80),respectively;for cerebral infarction,the HRs(95%CI)were 1.41(1.14―1.74),1.24(1.00―1.53),and 1.37(1.10―1.70),respectively;for cerebral hemorrhage,the HRs(95%CI)were 1.51(0.95―2.41),1.62(1.03―2.55),and 1.05(0.62―1.76),respectively;for all-cause mortality,the HRs(95%CI)were 1.09(0.97―1.21),1.21(1.09―1.35),and 1.37(1.23―1.52),respectively;and for the composite endpoint,the HRs(95%CI)were 1.18(1.06―1.30),1.26(1.14―1.38),and 1.40(1.27―1.54),respectively.Conclusion In the elderly hypertensive population,neutrophil count shows a positive correlation with cerebral infarction,all-cause mortality and composite endpoint event,while the risks of myocardial infarction and cerebral hemorrhage are the highest in the Q3 group[3.7≤neutrophil coun<4.6(×10⁹/L)].This suggests that neutrophil count may serve as a potential biological marker for evaluating cardiovascular and cerebrovascular events as well as all-cause mortality in elderly patients with hypertension.
作者
陶雅辉
郭晓斌
李子函
刘苹
TAO Ya-hui;GUO Xiao-bin;LI Zi-han;LIU ping(Department of General Medicine,the Second Hospital of Tangshan City,Hebei Province,Tangshan 063000,China;Department of Nutriology,Kailuan General Hospital,Hebei Province,Tangshan 063000,China)
出处
《河北医科大学学报》
2026年第3期309-315,共7页
Journal of Hebei Medical University
基金
河北省医学科学研究课题计划项目(20230233)。
关键词
高血压
中性粒细胞
心脑血管事件
全因死亡
hypertension
neutrophils
cardiovascular and cerebrovascular events
all-cause mortality
