中性粒细胞与淋巴细胞比值与原发性干燥综合征合并肺动脉高压的相关性分析

Relationship Between Neutrophil to Lymphocyte Ratio and Primary Sicca Syndrome with Pulmonary Artery Hypertension

目的探讨中性粒细胞与淋巴细胞比值(NLR)与原发性干燥综合征(pSS)合并肺动脉高压(PAH)的关系。方法选取2020年11月至2022年4月在信阳市中心医院确诊为pSS的98例患者作为研究对象,按照是否出现肺动脉高压分为PAH组(42例)和非PAH组(56例)。比较两组的临床资料、实验室指标、超声心动图、NLR,采用二元logistic回归分析pSS-PAH的影响因素,采用Pearson相关性分析NLR水平与肺动脉压的相关性,采用受试者工作特征曲线分析NLR对pSS-PAH的预测价值。结果PAH组与非PAH组的性别、年龄、病程、吸烟史、合并疾病类型、糖化血红蛋白(HbA1c)、白细胞计数(WBC)、中性粒细胞(NE)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、室间隔厚度(VST)比较差异无统计学意义(P>0.05),PAH组的NLR、左室舒张末期内径(LVEDD)、主动脉内径、左室收缩末期内径(LVESD)高于非PAH组,而淋巴细胞(LY)、左室射血分数(LVEF)低于非PAH组(P<0.05)。二元logistic回归分析结果显示,LY、NLR、LVESD、LVEF是PAH的影响因素,NLR与pSS患者肺动脉压呈正相关性(r=0.834,P<0.001),NLR诊断PAH的曲线下面积为0.668,灵敏度为60.6%,特异度为83.9%。结论NLR与pSS患者肺动脉压有紧密联系,NLR异常升高会增加pSS患者发生PAH风险,NLR对诊断pSS-PAH有一定临床参考价值。

Objective To explore the relationship between neutrophil to lymphocyte ratio(NLR)and primary sicca syndrome(pSS)with pulmonary artery hypertension(PAH).Methods Ninety-eight patients confirmed with pSS in Xinyang Central Hospital from November 2020 and April 2022 were selected as research objects,and they were divided into PAH group(42 cases)and non-PAH group(56 cases)according to whether there was PAH.The clinical data,laboratory indicators,ultrasound electrocardiogram,NLR levels between two groups were compared.Binary logistic regression was used to analyze the influencing factors of pSS-PAH,Pearson correlation was used to analyze the correlation between NLR level and pulmonary artery pressure,and the predictive value of NLR on pSS-PAH was analyzed using characteristic curve of subjects.Results There was no statistically significant difference between PAH group and non-PAH group in gender,age,course of disease,smoking history,type of concomitant disease,glycosylated hemoglobin(HbA1c),white blood cell(WBC),neutrophil(NE),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),and ventricular septal thickness(VST)(P>0.05).The NLR,left ventricular end-diastolic diameter(LVEDD),main aortic diameter and left ventricular end-systolic diameter(LVESD)of PAH group were higher than those of non-PAH group,while the lymphocyte count(LY)and left ventricular ejection fraction(LVEF)were lower than those of non-PAH group(P<0.05).The results of binary logistic regression analysis showed that LY,NLR,LVESD and LVEF were the influencing factors of PAH.NLR was positively correlated with pulmonary artery pressure in patients with pSS(r=0.834,P<0.001).The area under the curve value of NLR in diagnosis of PAH was 0.668,sensitivity was 60.6%,specificity was 83.9%.Conclusion NLR is closely related to pulmonary arterial pressure in patients with pSS.Abnormal increase of NLR will increase the risk of PAH in patients with pSS.NLR has certain clinical reference value for the diagnosis of pSS-PAH.