中性粒细胞与淋巴细胞比值预测心脏再同步治疗反应。
Neutrophil-to-lymphocyte ratio predicts response to cardiac resynchronization therapy.
机构信息
Department of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
出版信息
Med Sci Monit. 2013 May 17;19:373-7. doi: 10.12659/MSM.883915.
BACKGROUND
Neutrophil-to-lymphocyte (N/L) ratio has been associated with adverse outcomes in patients with acute coronary syndromes and increased risk for long-term mortality in patients with acute decompensated heart failure. We aimed to investigate the prognostic value of neutrophil-to-lymphocyte ratio on response to cardiac resynchronization therapy (CRT).
MATERIAL AND METHODS
Seventy consecutive patients (mean age 58 ± 13 years; 40 men) undergoing CRT were included in the study. Hematological and echocardiographic parameters were measured before and 6 months after CRT. Echocardiographic response to CRT was defined as a ≥ 15% reduction in left ventricular end-systolic volume at 6-month follow-up.
RESULTS
After 6 months of CRT, 49 (70%) patients were responders. After 6 months, left ventricular ejection fraction (LVEF) had significantly increased, from 21 ± 7% to 34 ± 11% in responder patients (p = 0.001). N/L ratio decreased significantly, from 2.4 ± 1 to 2.1 ± 0.7 in responders (p = 0.04). In multivariate analysis, significant associates of echocardiographic response to CRT was evaluated adjusting for age, etiology of cardiomyopathy, baseline LVEF, New York Heart Association functional class, C-reactive protein, and baseline N/L ratio. Baseline N/L ratio was the only predictor of response to CRT (OR 1.506, 95% CI, 1.011-2.243, p = 0.035).
CONCLUSIONS
N/L ratio at baseline could help to identify patients with response to CRT.
背景
中性粒细胞与淋巴细胞比值（N/L）与急性冠状动脉综合征患者的不良预后相关，并且与急性失代偿性心力衰竭患者的长期死亡率升高相关。我们旨在研究中性粒细胞与淋巴细胞比值对心脏再同步化治疗（CRT）反应的预测价值。
材料和方法
本研究纳入了 70 例连续接受 CRT 的患者（平均年龄 58±13 岁，40 名男性）。在 CRT 前后测量血液学和超声心动图参数。CRT 反应定义为 6 个月随访时左心室收缩末期容积减少≥15%。
结果
CRT 后 6 个月，49 例（70%）患者为应答者。CRT 后 6 个月，左心室射血分数（LVEF）从应答者的 21±7%显著增加至 34±11%（p=0.001）。N/L 比值从 2.4±1 显著降低至 2.1±0.7（p=0.04）。在多变量分析中，通过调整年龄、心肌病病因、基线 LVEF、纽约心脏协会功能分级、C 反应蛋白和基线 N/L 比值，评估 CRT 超声心动图反应的相关因素。基线 N/L 比值是 CRT 反应的唯一预测因素（OR 1.506，95%CI，1.011-2.243，p=0.035）。
结论
基线 N/L 比值有助于识别对 CRT 有反应的患者。
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