2019 年第 6 期 第 14 卷

中性粒细胞与淋巴细胞比值对主动脉夹层患者院内不良事件的预测价值

Predictive value of neutrophil to lymphocyte ratio for in-hospital adverse events in patients with aortic dissection

作者：王媛柯兵兵王雪姜文溪杜杰

英文作者：

单位：100029首都医科大学附属北京安贞医院北京市心肺血管疾病研究所心血管重塑相关疾病教育部重点实验室心血管重大疾病防治协同创新中心

英文单位：

关键词：主动脉夹层；中性粒细胞与淋巴细胞比值；院内不良事件

英文关键词：

• 摘要：

• 【摘要】目的    探讨中性粒细胞与淋巴细胞比值(NLR)对主动脉夹层患者院内不良事件的预测价值。方法    选取2012年1月至2014年12月在首都医科大学附属北京安贞医院就诊的主动脉夹层患者504例，收集患者临床资料进行回顾性分析。将所有患者按照NLR的平均值分为高NLR组（183例，NLR≥7.70）和低NLR组（321例，NLR＜7.70）。比较2组患者一般资料，分析主动脉夹层患者发生院内不良事件的危险因素。结果    高NLR组患者高血压史比例和白细胞计数、中性粒细胞计数及急性和A型主动脉夹层比例均高于低NLR组，淋巴细胞计数、红细胞计数和血小板计数低于低NLR组，差异均有统计学意义（均P＜0.05)。在A型主动脉夹层患者中，高NLR组总院内不良事件发生率明显高于低NLR组［24.8%(33/133)比15.5%(31/200)］，差异有统计学意义（P=0.035）。在B型主动脉夹层患者中，2组院内不良事件发生率比较，差异均无统计学意义（均P＞0.05）。Logistic回归分析显示NLR是A型主动脉夹层患者发生院内不良事件的独立危险因素（比值比=2.752，95%置信区间：1.043～7.262，P=0.041）。结论    NLR是A型主动脉夹层患者发生院内不良事件的独立危险因素。

• 【Abstract】Objective    To analyze the value of neutrophil to lymphocyte ratio in prediction of in-hospital adverse events in patients with aortic dissection. Methods    Clinical data of 504 patients with aortic dissection admitted to Beijing Anzhen Hospital, Capital Medical University from January 2012 to December 2014 were retrospectively analyzed. According to the mean value of NLR, the patients were divided into high NLR group(n=183, NLR≥7.70) and low NLR group(n=321, NLR＜7.70). Risk factors of in-hospital adverse events were analyzed. Results    Hypertension history rate, white blood cell count, neutrophil count, rates of acute and type A aortic dissection in high NLR group were higher than those in low NLR group; lymphocyte count, red blood cell count and platelet count in high NLR group were lower than those in low NLR group; the differences were significant(all P＜0.05). Among patients with type A aortic dissection, incidence of in-hospital adverse events in high NLR group was significantly higher than that in low NLR group ［24.8%(33/133) vs 15.5%(31/200)］(P=0.035). Among patients with type B aortic dissection, incidence of in-hospital adverse events showed no significant difference between groups(P＞0.05). Logistic regression indicated that NLR was an independent risk factor of in-hospital adverse events in patients with type A aortic dissection(odds ratio=2.752, 95% confidence interval: 1.043-7.262, P=0.041). Conclusion    NLR is an independent predictor of in-hospital adverse events in patients with type A aortic dissection.