频发性室性早搏患者外周血中性粒细胞-淋巴细胞比率与围术期心肌损伤的相关性分析

Correlation analysis of peripheral blood NLR and perioperative myocardial injury in patients with FVPB

目的:探讨频发性室性早搏患者外周血中性粒细胞-淋巴细胞比率(NLR)与心肌损伤的关系,为临床频发性室性早搏患者心肌保护提供参考依据。方法:选取2014-12~2016-03因频发性室性早搏就诊于我院心内科的患者200例,收集其血常规及频发性室性早搏发作后肌钙蛋白I(cTnI)及肌酸激酶同工酶(CK-MB),并计算NLR。根据患者NLR水平,使用四分位法将入组患者分为4组,比较各组之间cTnI及CK-MB峰值,回归分析峰值NLR与cTnI及CK-MB的相关性。结果:将200例频发性室性早搏患者按NLR水平分为4组,中位数NLR为2.34,第23和74百分位数为1.69和3.27。随着NLR的升高,高血压和射血分数<50%的患者比例增加,WBC、CK-MB及cTnI峰值、血肌酐值均显著增加,差异有统计学意义(P<0.05,P<0.01)。4组患者年龄、性别、体质量指数(BMI)、吸烟史、糖尿病史、高脂血症史、治疗前血肌酐、空腹血糖、血脂水平比较,差异无统计学意义(P>0.05)。多元逐步回归分析显示,本研究中的频发性室性早搏患者,外周血NLR与cTnI峰值呈正相关(r=0.538,P<0.05);与WBC亦呈正相关(r=0.661,P<0.05);cTnI峰值与WBC呈正相关(r=0.189,P<0.05),与高血压病史、射血分数、肌酐峰值及CK-MB等实验室检查结果无明显相关性,差异无统计学意义(P>0.05)。结论:频发性室性早搏患者外周血NLR与WBC、cTnI峰值呈正相关,因此,NLR是反映频发性室性早搏患者心肌损伤的良好标志物。

Objective：To investigate correlation of the peripheral blood neutrophil lymphocyte ratio（NLR）and myocardial injury in patients with frequent ventricular premature beat（FVPB）.Methods：A total of 200 patients with FVPB were selected from December 2014 to March 2016,preoperative white blood cells（WBC）,neutrophil（N）,lymphocyte（L）,postoperative troponin I（cTnI）and creatine kinase isoenzyme（CK-MB）were measured at admission.All patients were divided into four groups according to NLR.Difference in their peak cTnI and CK-MB values were compared and correlation of NLR with peak cTnI and CK-MB values was analyzed.Results：With the increment of NLR,the proportion of the history of hypertension,ejection fraction 〈50%,WBC,peak cTnI and CK-MB values were significantly higher in the upper group than those in the other groups（P〈0.05,P〈0.01）.Multiple stepwise regression analysis showed that the WBC and peak cTnI values were positively correlated with the NLR（r=0.661,r=0.538,P〈0.05）.Conclusion：The WBC count and peak cTnI values are positively correlated with NLR in patients with FVPB,so NLR is a good indication for perioperative myocardial injury in FVPB.