中性粒细胞/淋巴细胞比值与非瓣膜性心房颤动患者左心耳血栓的相关性分析

Relationship between neutrophil-to-lymphocyte ratio and left atrial appendage thrombus in patients with non-valvular atrial fibrillation

目的探讨非瓣膜性心房颤动(NVAF)患者中性粒细胞/淋巴细胞比值(NLR)与左心耳血栓(LAAT)的相关性。方法连续入选2014年1月—2021年12月在宁波市第一医院心血管内科住院且行经食道超声心动图提示LAAT的NVAF患者67例(LAAT组),并根据临床资料匹配145例无LAAT的患者(无LAAT组)。比较2组患者的NLR水平,采用多因素logistic回归分析NLR是否为LAAT的独立相关因素,通过受试者工作特征(ROC)曲线及曲线下面积(AUC)评估NLR水平对于判断是否存在LAAT的价值。结果LAAT组患者的NLR水平高于无LAAT组患者(P<0.05)。多因素logistic回归分析结果显示,NLR与LAAT存在独立相关(OR=9.35,95%CI:4.19~20.88,P<0.001)。ROC曲线的AUC为0.88(95%CI:0.83~0.92,P<0.001);当NLR≥2.6时,患者可能存在LAAT,其敏感度为83.6%,特异度为75.9%。结论在NVAF患者中,NLR水平与LAAT独立相关,高NLR水平对于预测LAAT的存在具有一定参考价值。

Objective To investigate the relationship between neutrophil-to-lymphocyte ratio(NLR)and left atrial appendage thrombus(LAAT)in patients with non-valvular atrial fibrillation(NVAF).Methods A total of 67 NVAF patients(LAAT group)with LAAT detected by transesophageal echocardiography from January,2014 to December,2021 in Ningbo First Hospital were collected.A total of 145 patients without LAAT(non-LAAT group)were matched according to clinical data.The level of NLR was compared between the two groups.Multivariate logistic regression was used to analyze whether NLR was an independent correlated factor of LAAT.The value of NLR level in judging the existence of LAAT was evaluated by receiver operating characteristic(ROC)curve and area under the curve(AUC).Results The level of NLR in LAAT group was higher than that in non-LAAT group(P<0.05).Multivariate logistic regression analysis showed that NLR was independently correlated with LAAT(OR=9.35,95%CI:4.19-20.88,P<0.001).The AUC of ROC curve was 0.88(95%CI:0.83-0.92,P<0.001).When NLR was≥2.6,LAAT might be present,with a sensitivity of 83.6%and a specificity of75.9%.Conclusion In NVAF patients,NLR level is independently correlated with LAAT.High NLR level has certain reference value for predicting the presence of LAAT.