摘要
目的:探讨中性粒细胞与淋巴细胞比值(NLR)对急性主动脉夹层(AAD)患者短期和长期死亡风险的预测价值.方法:回顾性分析141例AAD患者的临床资料,分组:①依据随访2周结果将患者分为死亡组(n=41)及存活组(n=100);②依据NLR 4分位数将患者分为NLR<4.33(Q1组,n=35),4.33≤NLR<7.26(Q2组,n=35),7.26≤NLR<11.78(Q3组,n=36),NLR≥11.78(Q4组,n=35).结果:短期内死亡组NLR显著高于存活组,死亡组NLR=9.67(6.81,13.07)、存活组NLR=6.18(3.63,11.10),死亡组的NLR水平比存活组的更高(P<0.05).KM生存曲线显示,Q4组的短期和长期死亡风险均明显高于其他3组.多因素Cox比例风险回归模型显示,与Q1组比较, Q4组增加短期死亡风险28倍,HR 28.403,95%CI 3.392(237.865),增加长期死亡风险3倍,HR 3.396,95%CI 1.596(7.228),有统计学差异(P<0.05).结论:入院NLR≥11.78可明显增加AAD患者的短期和长期死亡风险,NLR愈高,预后愈差.
Objective:To investigate the prognostic value of neutrophil to lymphocyte ratio(NLR) in short-and long-term mortality risk of patients with acute aortic dissection(AAD). Methods: A total of 141 patients diagnosed with AAD were collected for clinic data retrospectively. The Patients were divided into death group(n=41) and survival group(n=100) according to whether there was a death event in 2-week follow-up. According to the quartile count of NLR, the patients were divided into Q1 group(NLR<4.33, n=35), Q2 group(4.33≤NLR<7.26, n=35), Q3 group(7.26≤NLR<11.78, n=36) and Q4 group(NLR≥11.78, n=35). Results: The NLR was 9.67(6.81, 13.07) in deceased patients, which was significantly higher than that(6.18(3.63, 11.10)) in in survived patients(P<0.05). Kaplan-Meier analysis showed that the cumulative short-and long-term mortality risk was greatly higher in patients with elevated admission Q4 levels when compared with those with low admission NLR in the other 3 groups. In multivariate Cox regression analysis, it showed that elevated admission NLR(≥11.28) in Q4 group remained an independent predictor of short-term mortality of AAD(HR to 28.403, 95% CI 3.392~237.865) and long-term mortality(HR to 3.396, 95% CI 1.596~7.228)(all P<0.05). Conclusion:Admission NLR is an independent predictor of short-and long-term mortality risk in patients with AAD. The higher NLR, the poorer prognosis.
引文
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