中性粒细胞与淋巴细胞比值预测老年不稳定性心绞痛患者介入治疗远期预后

Value of neutrophil to lymphocyte ratio for predicting long-term outcome in elderly UAP patients after PCI

目的探讨中性粒细胞/淋巴细胞比值(NLR)与接受PCI的老年不稳定性心绞痛(UAP)患者远期预后的关系。方法连续纳入天津市胸科医院成功接受PCI的老年UAP患者514例,根据ROC曲线分析NLR预测PCI后2年主要不良心血管事件(MACE)的最佳临界值4.86,将患者分为高NLR(NLR≥4.86)组81例和低NLR(NLR<4.86)组433例,采用Cox风险比例模型分析。结果与低NLR组比较,高NLR组血小板/淋巴细胞比值升高(226.0±86.7 vs 137.8±51.3,P=0.000),MACE发生率升高(44.4%vs 8.1%,P<0.01)。Cox分析显示,NLR和年龄是MACE发生的独立预测因子(HR=1.434,95%CI:1.282~1.604,P<0.01;HR=1.040,95%CI:1.010~1.071,P<0.01)。结论NLR增高和高龄是老年UAP患者PCI后远期MACE增加的独立危险因素。

Objective To study the relationship of neutrophil to lymphocyte ratio(NLR)with the long-term outcome in elderly UAP patients after PCI.Methods Five hundred and fourteen elder-ly UAP patients who underwent successful PCI in our hospital were divided into high NLR group(n=81)and low NLR group(n=433)according to the optimal cut-off value(4.86)of NLR for predicting the incidence of MACE after 2 years of PCI as was shown in ROC curve analysis.By Cox propotional harzards model analysis.Results The PLR was significantly higher while the in-cidence of MACE was significantly lower in high NLR group than in low NLR group(226.0±86.7 vs 137.8±51.3,44.4%vs 8.1%,P<0.01).Cox propotional harzards model analysis showed that NLR and age were independent risk factors for the incidence of MACE in elderly UAP patients(HR=1.434,95%CI:1.282-1.604,P<0.01;HR=1.040,95%CI:1.010-1.071,P<0.01).Conclusion Elevated NLR and advanced age are the independent risk factors for long-term outcome and incidence of MACE in elderly UAP patients after PCI.