中性粒细胞/淋巴细胞比率对预测不稳定心绞痛患者冠脉病变严重程度和临床风险的意义

doi:10.12092/j.issn.1009-2501.2019.03.010

中国临床药理学与治疗学 ›› 2019, Vol. 24 ›› Issue (3): 296-300.doi: 10.12092/j.issn.1009-2501.2019.03.010

中性粒细胞/淋巴细胞比率对预测不稳定心绞痛患者冠脉病变严重程度和临床风险的意义

王夏芹¹，何非²，王同¹，胡章乐²

¹安徽医科大学第二附属医院全科医学科，合肥 230607，安徽； ²安徽医科大学第二附属医院心血管内科，合肥 230607，安徽

收稿日期:2019-02-21 修回日期:2019-03-10 出版日期:2019-03-26 发布日期:2019-04-01
通讯作者: 王同，男，主任医师，研究方向：常见内科慢性病的管理。 E-mail：bbmc_wt@163.com
作者简介:王夏芹，女，主治医师，研究方向：冠状动脉粥样硬化性心脏病的诊断和治疗。 E-mail:631247696@qq.com
基金资助:
安徽省自然科学青年基金资助项目（1808085QH235）

Admission Neutrophil-to-lymphocyte ratio predicts coronary lesion complexity and clinical risk in patients with unstable angina pectoris

WANG Xiaqin ¹， HE Fei ², WANG Tong¹, HU Zhangle ²

¹ Department of General Practice, the Second Hospital of Anhui Medical University, Hefei 230607，Anhui, China；² Department of Cardiology, the Second Hospital of Anhui Medical University, Hefei 230607，Anhui, China

Received:2019-02-21 Revised:2019-03-10 Online:2019-03-26 Published:2019-04-01

摘要/Abstract

摘要：

目的: 探讨不稳定心绞痛患者入院时的中性粒细胞/淋巴细胞比率与冠脉病变程度和临床风险之间的关系。方法: 回顾性分析156例患者入院时中性粒细胞/淋巴细胞比率、记录其临床特征和冠脉造影的结果。继之，分别对所有患者进行GRACE(global registry of acute coronary events，GRACE)评分、冠脉造影Gensini评分。根据中性粒细胞/淋巴细胞比率 (neutrophil-to-lymphocyte ratio，NLR)结果将患者分成低（low NLR）、中（medium NLR）、高（high NLR）NLR（LNLR,MNLR,HNLR）3组后，比较3组患者之间一般临床特征、GRACE评分、Gensini评分的差异并分析NLR与GRACE评分、Gensini评分的相关性。结果: HNLR组年龄、吸烟率、静息心率、低密度脂蛋白水平、血肌酐水平、高血压病史、高脂血症史、心电图ST段压低比率高于LNLR组（P均<0.01）。HNLR组他汀类药物使用比率显著低于LNLR组(P<0.01)。HNLR组GRACE评分、Gensini评分显著高于MNLR组及LNLR组(P均<0.01)；MNLR组GRACE评分、Gensini评分水平显著高于LNLR组(P均<0.01)。NLR与GRACE评分、Gensini评分呈现明显的正相关(P均<0.01)。结论: 入院时的NLR能够很好地预测不稳定心绞痛患者冠脉病变的严重程度以及临床风险；入院时循环中NLR越高，则冠脉病变程度越严重,提示临床风险越高。

关键词: 炎症, 中性粒细胞/淋巴细胞比率, 不稳定心绞痛

Abstract:

AIM: To study the association of admission neutrophil-to-lymphocyte ratio (NLR) with coronary lesion complexity and prognosis as respectively evaluated by Gensini score and GRACE（global Registry of Acute Coronary Events，GRACE） score in patients with unstable angina pectoris. METHODS: A total of 156 cases were retrospectively analyzed. All patients were assigned into 3 groups according to their NLR tertiles（low NLR,LNLR；Medium NLR, MNLR；High NLR, HNLR）. Clinical characteristics, risk and angiographic complexity attached to the 3 groups were compared. RESULTS:HNLR group exhibited much higher age，rest heart rate，LDL-C and blood creatine values and percentages of smoking, hypertension, diabetes mellitus, ST depression as compared with LNLR group(all P<0.01). However，the use rate of statins in HNLR group was significantly lower than that in LNLR group (P<0.01). The GRACE risk score and Gensini score were all significantly higher in HNLR group compared to MNLR and LNLR groups (all P<0.01). Both GRACE and Gensini scores illustrated significant positive correlations with NLR. CONCLUSION:Admission NLR positively mirrors clinical risk and angiographic complexity in unstable angina patients.

Key words: inflammation, neutrophil-to-lymphocyte ratio, unstable angina pectoris

中图分类号:

R541.4

王夏芹，何非，王同，胡章乐. 中性粒细胞/淋巴细胞比率对预测不稳定心绞痛患者冠脉病变严重程度和临床风险的意义[J]. 中国临床药理学与治疗学, 2019, 24(3): 296-300.

WANG Xiaqin， HE Fei, WANG Tong, HU Zhangle. Admission Neutrophil-to-lymphocyte ratio predicts coronary lesion complexity and clinical risk in patients with unstable angina pectoris[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2019, 24(3): 296-300.

参考文献

［1］Vaccarezza M, Balla C, Rizzo P. Atherosclerosis as an inflammatory disease: Doubts? No more［J］. Int J Cardiol Heart Vasc, 2018,19:1-2.
［2］Rymer JA,Newby LK.Failure to launch:targeting inflammation in acute coronary syndromes［J］.JACC Basic Transl Sci,2017,2(4):484-497.
［3］Arshad MK, Bin Mohamad Fathil MF, Gopinath SC, et al. Cardiac biomarkers: invasive to non-invasive assessments［J］. Curr Med Chem, 2016,23(37):4270-4284.
［4］Lahdentausta L, Leskela J, Winkelmann A, et al. Serum MMP-9 diagnostics, prognostics, and activation in acute coronary syndrome and its recurrence［J］. J Cardiovasc Transl Res,2018,11(3):210-220.
［5］Sadeghi M, Gheraati M, Soleimani A, et al. Serum interleukin-18 and extent of coronary artery disease in unstable angina［J］. ARYA Atheroscler, 2018,14(3):122-127.
［6］Korzonek-Szlacheta I, Hudzik B, Danikiewicz A, et al. Pentraxin-3 and coronary artery disease［J］. Exp Gerontol, 2018,102:1-2.
［7］Horne BD, Anderson JL, John JM, et al. Which white blood cell subtypes predict increased cardiovascular risk［J］? J Am Coll Cardiol, 2005,45(10):1638-1643.
［8］Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill［J］. Bratisl Lek Listy, 2001,102(1):5-14.
［9］Tahto E, Jadric R, Pojskic L, et al. Neutrophil-to-lymphocyte Ratio and Its Relation with Markers of Inflammation and Myocardial Necrosis in Patients with Acute Coronary Syndrome［J］. Med Arch, 2017,71(5):312-315.
［10］Tamhane UU, Aneja S, Montgomery D, et al. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome［J］. Am J Cardiol, 2008,102(6):653-657.
［11］Crea F, Libby P. Acute coronary syndromes: the way forward from mechanisms to precision treatment［J］. Circulation, 2017,136(12):1155-1166.
［12］Balta S, Celik T, Mikhailidis DP, et al. The relation between atherosclerosis and the neutrophil-lymphocyte ratio［J］. Clin Appl Thromb Hemost, 2016,22(5):405-411.
［13］Bhat T, Teli S, Rijal J, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review［J］. Expert Rev Cardiovasc Ther, 2013,11(1):55-59.
［14］Mori M, Shuto K, Kosugi C, et al. An increase in the neutrophil-to-lymphocyte ratio during adjuvant chemotherapy indicates a poor prognosis in patients with stage II or III gastric cancer［J］. BMC Cancer, 2018, 18(1):1261.
［15］Kaya H, Ertas F, Islamoglu Y, et al. Association between neutrophil to lymphocyte ratio and severity of coronary artery disease［J］. Clin Appl Thromb Hemost, 2014, 20(1):50-54.
［16］Nunez J, Nunez E, Bodi V, et al. Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction［J］. Am J Cardiol, 2008,101(6):747-752.
［17］Azab B, Zaher M, Weiserbs KF, et al. Usefulness of neutrophil to lymphocyte ratio in predicting short- and long-term mortality after non-ST-elevation myocardial infarction［J］. Am J Cardiol, 2010,106(4):470-476.
［18］Gul M, Uyarel H, Ergelen M, et al. Predictive value of neutrophil to lymphocyte ratio in clinical outcomes of non-ST elevation myocardial infarction and unstable angina pectoris: a 3-year follow-up［J］. Clin Appl Thromb Hemost, 2014,20(4):378-384.
［19］Soylu K, Yuksel S, Gulel O, et al. The relationship of coronary flow to neutrophil/lymphocyte ratio in patients undergoing primary percutaneous coronary intervention［J］. J Thorac Dis, 2013,5(3):258-264.
［20］Yan SD, Liu XJ, Peng Y, et al. Admission Serum Calcium Levels Improve the GRACE Risk Score Prediction of Hospital Mortality in Patients With Acute Coronary Syndrome［J］. Clin Cardiol, 2016,39(9):516-523.
［21］Kundi H. The role of platelet-lymphocyte ratio in the severity of coronary artery disease assessed by the angiographic Gensini score［J］. Anatol J Cardiol, 2016,16(3):224.

[1]	廖梦玲, 汪艳, 罗静, 王诺妍, 华玲, 张瑜, 邓非, 袁月, 周军, 周红. 青蒿琥酯抑制巨噬细胞释放前炎症细胞因子的分子作用机制研究[J]. 中国临床药理学与治疗学, 2023, 28(9): 969-978.
[2]	王鑫昱, 陈亦鹏, 马永力, 何君妃. “杜仲-当归”调控NLPR3炎症小体对骨关节炎大鼠改善作用的研究[J]. 中国临床药理学与治疗学, 2023, 28(7): 751-757.
[3]	李雅亭, 岳红梅, 刘苗苗, 许金回, 武兴东, 朱浩斌. 磷酸二酯酶4抑制剂作为特发性肺纤维化药物治疗的可能性[J]. 中国临床药理学与治疗学, 2023, 28(7): 818-823.
[4]	赵灵芝, 何艳君, 谢建琴, 尤崇革. rhsTM对动脉粥样硬化的治疗作用机制研究进展[J]. 中国临床药理学与治疗学, 2023, 28(7): 832-840.
[5]	李阳, 潘维忠, 张晓录, 于翠翠. 回收式自体血回输对行剖宫产术患者免疫功能及炎症反应的影响[J]. 中国临床药理学与治疗学, 2023, 28(5): 514-524.
[6]	侯瑞英, 郭莉阁, 焦伟杰, 杜蕾, 吴桂月, 赵旭. 消渴舒方对2型糖尿病模型大鼠血清炎症因子的影响及其机制研究[J]. 中国临床药理学与治疗学, 2023, 28(4): 377-382.
[7]	李军民, 牛恒立, 谢明全, 苏金龙. 山楂黄酮抗动脉粥样硬化及降血脂作用机制研究[J]. 中国临床药理学与治疗学, 2023, 28(3): 276-282.
[8]	黄玉荣, 张红强, 游蓉丽, 贾颖, 王艳, 樊杰, 王颖莉. 青黛散外用凝胶对特异性皮炎小鼠的改善作用研究[J]. 中国临床药理学与治疗学, 2023, 28(1): 19-28.
[9]	王欣, 孙合亮, 张庆伟, 刘存明, 王忠云, 杨春. 小剂量艾司氯胺酮在胸腔镜下肺叶切除术患者术后镇痛中的作用[J]. 中国临床药理学与治疗学, 2022, 27(9): 998-1003.
[10]	毛姝英, 金蔚, 付思思, 刘珂安琪, 周志豪, 王广基, 梁艳. 口服脾多肽改善氨水诱导的小鼠咳嗽和体内炎症[J]. 中国临床药理学与治疗学, 2022, 27(6): 601-607.
[11]	金依依, 周科挺, 杨成成, 徐萍, 朱素燕. 蛇床子素抑制NF-κB和p38/MAPK改善糖尿病诱导的肾脏损伤[J]. 中国临床药理学与治疗学, 2022, 27(6): 622-631.
[12]	于泽芳, 范理菊, 尹晓玉, 高丽丽, 董占军. 新型速效抗抑郁药的研究进展[J]. 中国临床药理学与治疗学, 2022, 27(5): 595-600.
[13]	高家荣, 施苗苗, 陈浩, 姜辉, 秦秀娟. 芪藤消浊颗粒介导miR-339-5p对慢性肾小球肾炎大鼠炎症指标的影响[J]. 中国临床药理学与治疗学, 2022, 27(4): 457-465.
[14]	常书福. 冠心病药物治疗进展[J]. 中国临床药理学与治疗学, 2022, 27(4): 405-408.
[15]	王瑞杰, 王亮, 徐丹, 周淼淼, 李纪明. PCSK9抑制剂对冠心病患者血脂及炎症因子的影响[J]. 中国临床药理学与治疗学, 2022, 27(4): 409-417.

中性粒细胞/淋巴细胞比率对预测不稳定心绞痛患者冠脉病变严重程度和临床风险的意义

Admission Neutrophil-to-lymphocyte ratio predicts coronary lesion complexity and clinical risk in patients with unstable angina pectoris

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价