2025 年第 1 期 第 0 卷

中性粒细胞与淋巴细胞比值和系统性免疫炎症指数与颈动脉粥样硬化的相关性研究

The correlation of neutrophil to lymphocyte ratio and systemic immune inflammation index with carotid atherosclerosis

作者：尼格尔·艾白都拉  郑颖颖

英文作者：Nigeer Aibaidula Zheng Yingying

单位：新疆医科大学第一附属医院心力衰竭科，乌鲁木齐830054

英文单位：Department of Heart Failure the First Affiliated Hospital of Xinjiang Medical University Urumqi 830054 China

关键词：颈动脉粥样硬化；  中性粒细胞与淋巴细胞比值；  系统性免疫炎症指数

英文关键词：Carotidatherosclerosis;  Neutrophiltolymphocyteratio;  Systemicimmuneinflammationindex

• 摘要：

• 目的  探讨中性粒细胞与淋巴细胞比值（NLR）、系统性免疫炎症指数（SII）与颈动脉粥样硬化（CAS）的相关性，以及二者对CAS的预测作用。方法  选取2020年1月至2023年1月在新疆医科大学第一附属医院心脏中心治疗的400例患者，根据颈动脉超声结果分为CAS组（157例）和非CAS组（243例）。再将CAS组根据颈动脉斑块情况分为颈动脉内膜增厚组、单发斑块组和多发斑块组。比较各组临床基本资料、血常规、血生化指标，分析CAS组患者斑块数量与Crouse积分的相关性。采用多因素Logistic回归方法分析CAS发生的独立危险因素。采用受试者工作特征（ROC）曲线分析NLR、SII单独及联合预测CAS的价值。结果  CAS组患者的年龄、收缩压、Crouse积分和吸烟史、高血压病史、冠心病（冠状动脉粥样硬化性心脏病）史、糖尿病史、近期服用降脂药物者比例均高于非CAS组，差异均有统计学意义（均P＜0.05）。CAS组NLR、SII均高于非CAS组［（2.2±0.9）比（1.8±0.7）、（506±229）比（418±157）］，差异均有统计学意义（均P＜0.05）。CAS组甘油三酯、低密度脂蛋白胆固醇（LDL-C）、空腹血糖、糖化血红蛋白（HbA1c）均高于非CAS组，差异均有统计学意义（均P＜0.05）。多发斑块组Crouse积分高于单发斑块组，差异有统计学意义（P＜0.05）。多因素Logistic回归分析结果显示，冠心病、NLR、SII、甘油三酯、LDL-C、HbA1c均是CAS发生的独立危险因素（均P＜0.05）。ROC曲线分析结果显示，NLR预测CAS的曲线下面积（AUC）达到0.62（95%置信区间：0.57～0.68），SII预测CAS的AUC为0.60（95%置信区间：0.54～0.65），二者联合时预测CAS的AUC增至0.72（95%置信区间：0.67～0.77）。结论  NLR和SII与CAS的发生密切相关，对CAS的发生均具有一定的预测价值，二者联合时对CAS的预测价值提升。

• Objective  To investigate the correlation between neutrophil to lymphocyte ratio (NLR), systemic immune inflammation index (SII) and carotid atherosclerosis (CAS), and their predictive value for CAS. Methods   A total of 400 patients who were treated in the heart center of the First Affiliated Hospital of Xinjiang Medical University from January 2020 to January 2023 were selected, and they were divided into CAS group (157 cases) and non-CAS group (243 cases) according to the results of carotid ultrasound. The CAS group was further divided into carotid intima-media thickening group, single plaque group and multiple plaque group according to the carotid plaque. The basic clinical data, blood routine and blood biochemical indexes of each group were compared, and the correlation between the number of plaques and Crouse score in CAS group was analyzed. Multivariate Logistic regression was used to analyze the independent risk factors of CAS. The receiver operating characteristic (ROC) curve was used to analyze the value of NLR, SII alone and combined in predicting CAS. Results   The age, systolic blood pressure, Crouse score, smoking history, history of hypertension, history of coronary atherosclerotic heart disease, history of diabetes mellitus, and proportion of recent use of lipid-lowering drugs in the CAS group were higher than those in the non-CAS group (all P＜0.05). NLR and SII in CAS group were higher than those in non-CAS group ［(2.2±0.9) vs (1.8±0.7), (506±229) vs (418±157)］(both P＜0.05). Triglyceride, low-density lipoprotein cholesterol (LDL-C), fasting blood glucose and glycosylated hemoglobin (HbA1c) in the CAS group were higher than those in the non-CAS group (all P＜0.05). Crouse score of multiple plaque group was higher than that of single plaque group (P＜0.05). Multivariate Logistic regression analysis showed that coronary atherosclerotic heart disease, NLR, SII, triglyceride, LDL-C and HbA1c were independent risk factors for CAS (all P＜0.05). ROC curve analysis showed that the area under the curve (AUC) of NLR for predicting CAS was 0.62 (95% confidence interval: 0.57-0.68), and the AUC of SII for predicting CAS was 0.60 (95% confidence interval: 0.54-0.65), and the AUC for predicting CAS increased to 0.72 (95% confidence interval: 0.67-0.77) when the two were combined. Conclusion   NLR and SII are closely related to the occurrence of CAS, and both have certain predictive value for CAS. The predictive value of CAS can be improved when NLR and SII are combined.