中性粒细胞/淋巴细胞比值与急性主动脉夹层患者短期预后关系的Meta分析

Impact of the neutrophil/lymphocyte ratio on the prognosis of short term outcomes in acute aortic dissection patients:a meta-analysis

目的系统评价中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)与急性主动脉夹层患者短期预后的关系。方法计算机检索PubMed、Web of Science、CNKI、CBM和WanFang Data数据库,搜集中性粒细胞/淋巴细胞比值与急性主动脉夹层短期预后相关性的研究,检索时限均从建库至2021年7月。由2名评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4软件进行Meta分析。结果共纳入10个病例-对照研究,包括1638例患者。Meta分析结果显示:急性主动脉夹层患者院内死亡组的NLR值明显高于存活组[MD=4.94,95%CI(2.67,7.61),P<0.0001]。急性主动脉夹层患者低NLR组与较高NLR组的院内死亡率差异无统计学意义[OR=3.03,95%CI(1.00,9.15),P=0.05]。结论急性主动脉夹层患者院内死亡组NLR值较存活组明显升高,但尚不确定NLR与死亡率正相关。但受纳入研究质量和数量的限制,上述结论尚需开展更多高质量研究予以验证。

Objective To systematically review the relationship between the neutrophil to lymphocyte ratio(NLR)and the short-term prognosis of patients with acute aortic dissection.Method Databases including PubMed,Web of Science,CNKI,CBM,and WanFang Data were electronically searched to collect studies on the prognosis associated with neutrophil/lymphocyte ratio and acute aortic dissection from inception to July 2021.Two reviewers independently screened literature,extracted data,and evaluated the risk of bias of the included studies.Meta-analysis was then performed using RevMan 5.4 software.Results A total of 10 case-control studies involving 1638 patients were included.The results of meta-analysis revealed that the in-hospital mortality group of patients with acute aortic dissection had higher NLR levels than the survival group(MD=4.94,95%CI 2.67 to 7.61,P<0.0001).In patients with acute aortic dissection,there was no statistical difference in in-hospital mortality between the low NLR group and the high NLR group(OR=3.03,95%CI 1.00 to 9.15,P=0.05).Conclusion Patients with acute aortic dissection who died in hospital shows higher NLR levels than those who survived.However,due to the quantity and quality of included studies,the above conclusions are needed to be verified by more high-quality studies.