中性粒细胞与淋巴细胞的比率对急性STEMI住院病死率的预测价值

Usefulness of Neutrophil to Lymphocyte Ratio in Predicting In-hospital Mortality in ST segment Elevation Myocardial Infarction

目的:探讨中性粒细胞/淋巴细胞比率(NLR)与急性ST段抬高心肌梗死(STEMI)患者临床特点和住院病死率的关系。方法:入选STEMI患者584例,入院后即刻及72小时内每日抽取静脉血查血常规,按平均NLR的大小将其分为A、B两组,对两组患者临床特点和住院病死率进行比较。结果:B组心率、肌钙蛋白峰值显著高于A组,而且B组患者平均年龄较高,合并高血压及糖尿病的比例较高,收缩压偏低,Klilip分级Ⅲ～Ⅳ级患者比例增多,差异均具有统计学意义。但B组患者吸烟率及体质指数(BMI)却低于A组患者。B组患者住院死亡率(6.6%)明显高于A组患者(2.1%)。logistic回归分析显示NLR与STEMI患者住院病死率有显著的相关性。结论:NLR是STEMI患者住院病死率的可靠预测指标。

Objective： To investigate the relationship between neutrophil/lymphocyte ratio（NLR） and the likelihood of poor outcomes in patients with ST segment elevation myocardial infarction （STEMI）.Methods： A total of 594 patients with STEMI whose blood routines were obtained at the admission and daily during the first 72 hours were studied All cases ware divided into two groups according to average NLR. Then we analyzed the all-cause inpatient mortality of STEMI between the two groups, Results：Most cardiovascular disease risk factors were significantly higher in group B compared to those in group A. However prevalence of positive smoking history and body mass index level, significantly decreased with increasing average NLR. Patients in group B had a higher in-hospital mortality rate （6.6% vs 2.1%） compared to group A. By logistic regression analysis including baseline demographic, clinical covariables, NLR remained a significant predictor of inpatient mortality. Conclusions：NLR is a reliable indicator that can predict all-cause mortality in patients with STEMi.