[1]谭莹 毛雅晶 马楠 鲍雪 康丽娜 徐标.中性粒细胞与淋巴细胞比值对STEMI再灌注损伤后微血管阻塞的预测价值[J].心血管病学进展,2023,(1):87-91.[doi:10.16806/j.cnki.issn.1004-3934.2023.01.019]
　TAN YingMAO Yajing MA NanBAO XueKANG LinaXU Biao.Predictive Value of Neutrophil-to-Lymphocyte Ratio for MVO After STEMI Reperfusion Injury[J].Advances in Cardiovascular Diseases,2023,(1):87-91.[doi:10.16806/j.cnki.issn.1004-3934.2023.01.019]
点击复制

中性粒细胞与淋巴细胞比值对STEMI再灌注损伤后微血管阻塞的预测价值()
分享到：

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2023年1期
页码:
87-91
栏目:
论著
出版日期:
2023-01-25

文章信息/Info

Title:
Predictive Value of Neutrophil-to-Lymphocyte Ratio for MVO After STEMI Reperfusion Injury
作者:
谭莹1 毛雅晶 1 马楠2 鲍雪1 康丽娜 1 徐标1
(1.南京大学医学院附属鼓楼医院心血管内科,江苏 南京 210008;2.南京大学医学院附属金陵医院,江苏 南京 210002)
Author(s):
TAN Ying1MAO Yajing 1MA Nan2BAO Xue1KANG Lina1XU Biao1
(1. Department of Cardiology,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008, Jiangsu,China; 2.Jinling Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210002, Jiangsu,China)
关键词:
ST段抬高心肌梗死; 中性粒细胞与淋巴细胞比值; 心脏磁共振; 缺血再灌注损伤; 微血管阻塞
Keywords:
ST segment elevation myocardial infarction; Neutrophil-to-lymphocyte ratio; Cardiac magnetic resonance; Ischemia reperfusion injury; Microvascular obstruction
DOI:
10.16806/j.cnki.issn.1004-3934.2023.01.019
摘要:
目的 探讨 中性粒细胞与淋巴细胞比值（NLR）与急性ST段抬高心肌梗死（STEMI）的再灌注损伤后微血管阻塞的关系。方法 收集2018年10月—2020年12月在南京大学医学院附属鼓楼医院首次行急诊经皮冠状动脉介入治疗(PCI)的86例STEMI患者的资料，术后 1周行心脏磁共振检查，分析微血管阻塞(MVO)面积及MVO与左心室的比值，分成轻中度、重度MVO两组，比较两组之间的NLR、C反应蛋白以及低密度脂蛋白胆固醇等指标的差异，分析NLR与MVO严重程度的关联。以NLR为自变量，MVO为因变量，计算ROC曲线下面积。结果 重度MVO组的术前白细胞计数、中性粒细胞百分率和NLR均显著高于轻中度MVO组。多因素 逻辑回归分析显示，NLR是MVO严重程度的危险因素（P＜0.05）。NLR对MVO的cut-off值是4.210 3，NLR对重度MVO的敏感度是76.3%，特异度是66.7%。结论 NLR可预测STEMI患者PCI后MVO的严重程度，NLR升高的STEMI患者的MVO面积显著增加。
Abstract:
Objective To investigate the association of neutrophil-to-lymphocyte ratio(NLR) with microvascular obstruction after reperfusion injury in acute ST segm ent elevation myocardial infarction(STEMI). Methods 86 STEMI patients who underwent emergency percutaneous coronary intervention(PCI) in Nanjing Drum Tower Hospital ,The Affiliated Hospital of Nanjing University Medical School from October 2018 to December 2020 were enrolled. Cardiac magnetic resonance examination was performed o ne week after the operation,and microvascular obstruction(MVO) area and ratio of MVO to left ventricle were a nalysed. Then patients were divided into two groups:mild MVO and severe MVO. NLR,C-reactive pro tein,low-density lipoprotein cholesterol and other related indicators between the two groups were compared,and the correlation between NLR and MVO severity was analyzed. The area under the ROC curve was calculated with NLR as the independent variable and MVO as the dependent variable. Results The preoperative white blood cell count,neutrophil percentage and NLR in severe MVO group were significantly higher than those in mild to moderate MVO group. Multivariate logistic regression analysis showed that NLR is a risk factor for MVO severity(P＜0.05). The cut-off value of NLR to MVO was 4.210 3,and the sensitivity and specificity of NLR to severe MVO were 76.3% and 66.7% respectively. Conclusion NLR can predict the severity of MVO in STEMI patients after PCI,and the area of MVO in STEMI patients with elevated NLR is significantly increased

参考文献/References:

[1] Bergmark BA,Mathenge N,Merlini PA,et al. Acute coronary syndromes[J]. Lancet,2022,399(10332):1347-1358.

[2] GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories,1990—2019:a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet,2020,396(10258):1204-1222.

[3] Barnett R. Acute myocardial infarction[J]. Lancet,2019,393(10191):2580.

[4] Bhatt DL,Lopes RD,Harrington RA. Diagnosis and treatment of acute coronary syndromes:a review[J]. JAMA,2022,327(7):662-675.

[5] Heusch G. Myocardial ischaemia-reperfusion injury and cardioprotection in perspective[J]. Nat Rev Cardiol,2020,17(12):773-789.

[6] Mangold A,Ondracek AS,Hofbauer TM,et al. Culprit site extracellular DNA and microvascular obstruction in ST-elevation myocardial infarction[J]. Cardiovasc Res,2022,118(8):2006-2017.

[7] Liu T,Howarth AG,Chen Y,et al. Intramyocardial hemorrhage and the “wave front” of reperfusion injury compromising myocardial salvage[J]. J Am Coll Cardiol,2022,79(1):35-48.

[8] Symons R,Pontone G,Schwitter J,et al. Long-term incremental prognostic value of cardiovascular magnetic resonance after ST-segment elevation myocardial infarction:a study of the collaborative registry on CMR in STEMI[J]. JACC Cardiovasc Imaging,2018,11(6):813-825.

[9] García-Prieto J,Villena-Gutiérrez R,Gómez M,et al. Neutrophil stunning by metoprolol reduces infarct size[J]. Nat Commun,2017,8:14780.

[10] 宋欢. 中性粒细胞和淋巴细胞比值与急性心肌梗死相关性研究进展[J]. 心血管病学进展,2019,40(2):257-259.

[11] Silvestre-Roig C,Braster Q,Ortega-Gomez A,et al. Neutrophils as regulators of cardiovascular inflammation[J]. Nat Rev Cardiol,2020,17(6):327-340.

[12] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会. 急性ST段抬高型心肌梗死诊断和治疗指南(2019)[J].中华心血管病杂志,2019,47(10):766-783.

[13] 刘富湘，莫介超,陈注有,等. 急性ST段抬高型心肌梗死患者急诊PCI术前中性粒细胞与淋巴细胞比率和TIMI风险评分的关系[J]. 广东医科大学学报,2021,39(3):293-298.

[14] Hausenloy DJ,Yellon DM. Myocardial ischemia-reperfusion injury:a neglected therapeutic target[J]. J Clin Invest,2013,123(1):92-100.

[15] 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.

[16] Zhang S,Diao J,Qi C,et al. Predictive value of neutrophil to lymphocyte ratio in patients with acute ST segment elevation myocardial infarction after percutaneous coronary intervention:a meta-analysis[J]. BMC Cardiovasc Disord,2018,18(1):75.

[17] Reed GW,Rossi JE,Cannon CP. Acute myocardial infarction[J]. Lancet,2017,389(10065):197-210.

[18] Kyne L,Hausdorff JM,Knight E,et al. Neutrophilia and congestive heart failure after acute myocardial infarction[J]. Am Heart J,2000,139(1 Pt 1):94-100.

[19] Yu C,Chen M,Chen Z,et al. Predictive and prognostic value of admission neutrophil-to-lymphocyte ratio in patients with CHD[J]. Herz,2016,41(7):605-613.

[20] Machado GP,Araujo GN,Carpes CK,et al. Comparison of neutrophil-to-lymphocyte ratio and mean platelet volume in the prediction of adverse events after primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction[J]. Atherosclerosis,2018,274:212-217.

[21] Lucci C,Cosentino N,Genovese S,et al. Prognostic impact of admission high-sensitivity C-reactive protein in acute myocardial infarction patients with and without diabetes mellitus[J]. Cardiovasc Diabetol,2020,19(1):183.

相似文献/References:

[1]陈佳仑 李树仁.不同策略血栓抽吸对于急性ST段抬高心肌梗死患者的研究进展[J].心血管病学进展,2021,(7):593.[doi:10.16806/j.cnki.issn.1004-3934.2021.07.005]
　CHEN Jialun,LI Shuren.Different Strategies of Thrombus Aspiration in Patients with Acute ST Elevation Myocardial Infarction[J].Advances in Cardiovascular Diseases,2021,(1):593.[doi:10.16806/j.cnki.issn.1004-3934.2021.07.005]
[2]崔茜 裴汉军.主动脉内球囊反搏治疗急性ST段抬高心肌梗死合并心源性休克的研究进展[J].心血管病学进展,2021,(7):597.[doi:10.16806/j.cnki.issn.1004-3934.2021.07.006]
　CUI Qian,PEI Hanjun.Treatment of Acute ST Segment Elevation Myocardial Infarction Complicated with Cardiogenic Shock by Intra-aortic Balloon Counterpulsation[J].Advances in Cardiovascular Diseases,2021,(1):597.[doi:10.16806/j.cnki.issn.1004-3934.2021.07.006]
[3]夏平.“8+2”心电图临床价值的研究进展夏平[J].心血管病学进展,2021,(9):800.[doi:【DOI】10.16806/j.cnki.issn.1004-3934.2021.09.009]
　XIA Ping.Clinical Value of 8 Plus 2 ECG[J].Advances in Cardiovascular Diseases,2021,(1):800.[doi:【DOI】10.16806/j.cnki.issn.1004-3934.2021.09.009]
[4]李荣富 王高生 何宗保 范西真.HEART评分联合NLR对NSTE-ACS患者MACE的预测价值[J].心血管病学进展,2023,(1):92.[doi:10.16806/j.cnki.issn.1004-3934.2023.01.020]
　LI Rongfu,WANG Gaosheng,HE Zongbao,et al.The Predictive Value of HEART Score Combined with NLR for MACE in Patients with NSTE-ACS[J].Advances in Cardiovascular Diseases,2023,(1):92.[doi:10.16806/j.cnki.issn.1004-3934.2023.01.020]

更新日期/Last Update: 2023-03-10