急性ST段抬高型心肌梗死患者血液中性粒细胞/淋巴细胞比值、内皮细胞特异性分子-1水平与近期预后的关系

Relationship between neutrophil to lymphocyte ratio and endothelial cell specific molecule-1 level and short-term prognosis in patients with acute ST-segment elevation myocardial infarction

目的：探讨ST段抬高型心肌梗死（ST-segment elevation myocardial infarction,STEMI）患者血液中性粒细胞/淋巴细胞比值（neutrophil to lymphocyte ratio,NLR）、内皮细胞特异性分子-1（endothelial cell specific molecule-1,ESM-1）水平及与近期预后的关系。方法：序贯入选急性STEMI患者105例,同时纳入健康成年对照组33例,比较两组NLR、ESM-1水平差异,并记录STEMI患者住院期间及出院后3个月主要不良心血管事件（major adverse cardiovascular events,MACE）。Logistic回归分析MACE发生的危险因素。结果：STEMI组NLR、ESM-1水平明显高于对照组（P=0.00）。相关性分析表明,NLR与TIMI积分（r=0.19,P=0.04）,肌钙蛋白（r=0.26,P=0.01）呈正相关。单因素Logistic回归显示,NLR（OR：1.095,95%CI：1.0211.175,P=0.01）、ESM-1〉1.01μg/L（OR：3.011,95%CI：1.0498.642,P=0.04）、年龄（OR：1.044,95%CI：1.0081.082,P=0.02）、HDL-C（OR：6.692,95%CI：1.69526.426,P=0.01）、LDL-C（OR：1.701,95%CI：1.1482.522,P=0.01）、TIMI评分（OR：1.408,95%CI：1.1641.704,P=0.00）为MACE发生的危险因素。多因素Logistic回归显示NLR（OR：1.113,95%CI：1.0261.207,P=0.01）、ESM-1〉1.01μg/L（OR：3.543,95%CI：1.07911.632,P=0.04）为MACE发生的危险因素。结论：STEMI患者NLR、ESM-1浓度〉1.01μg/L可能对发生MACE具有预测价值。

Objeetive： To investigate the relationship between neutrophil to lymphocyte ratio（NLR） and endothelial cell specific molecule-1 （ ESM-1 ） level in patients with acute ST-segment elevation myocardial infarction（STEMI）. Methods： A total of 105 patients with STEMI and 33 individuals as a control group were included in the study. The level of NLR and ESM-1 were analyzed in two groups. The patients with STEMI were followed-up for three months, and major adverse cardiovascular events （MACE） was recorded. Logistic regression analysis was used to analyze the risk factor for MACE. Results ： Compared to the control group, NLR and serum ESM-1 level were significantly higher in patients with STEMI （ P =0.00）. In these patients,NLR were positive correlated with TIMI risk score and troponin （r = 0.19, P = 0.04 ; and r = 0.26, P = 0.01, respectively）. Univariate Logistic regression analysis indicated that NLR [odds ration （OR）： 1.095,95% confidence interval（CI）： 1.021 -1.175, P=0.01],ESM-1 〉1.01 μg/L （OR： 3.011,95% CI：1.049-8.642, P=0.04）,age （OR：1.044,95% CI： 1.008 -1.082, P=0.02）,HDL- C（OR： 6. 692,95%, CI： 1. 695 - 26. 426, P =0.01）,LDL-C（OR：1.701,95% CI：1.148-2.522,P =0. 01 ） ,TIMI risk seore（OR：1.408,95% CI：1. 164 - 1.704, P =0.00） were the predictors of MACE. Multi- variate Logistic regression analysis indicated that NLR（ OR： 1. 113,95% CI： 1. 026 - 1. 207, P = 0.01 ） ,ESM-1 level 〉 1.01 μg/L （ OR：3. 543,95% CI： 1. 079 - 11. 632, P =0.04） were the predictors of MACE. Conclusion： NLR and an ESM-1 level 〉 1.01 μg/L were likely to predict a greater risk of MACE in patients with STEMI.