Tanındı Aslı, Erkan Aycan Fahri, Ekici Berkay, Alhan Aslıhan, Töre Hasan Fehmi
Department of Cardiology, Ufuk University Faculty of Medicine, Ankara, Turkey.
Department of Statistics, Ufuk University Faculty of Arts and Sciences, Ankara, Turkey.
Turk Kardiyol Dern Ars. 2014 Mar;42(2):125-30. doi: 10.5543/tkda.2014.18949.
We investigated the relation between neutrophil to lymphocyte ratio (N/L) and the extent, severity, and complexity of coronary artery disease (CAD) and myocardial perfusion.
One hundred and fifty-one patients who underwent coronary angiography with stable angina pectoris (SAP) (n=93) or acute coronary syndrome (ACS) (n=58) were included in the study. Blood samples were drawn before coronary angiography. Gensini and SYNTAX scores and myocardial blush grade (MBG) were assessed.
Neutrophil counts were 4.4±1.4 and 5.0±1.6 in the SAP and ACS groups (p=0.018), whereas lymphocyte counts were 2.2±0.7 and 2.1±0.7, respectively (p=0.104). N/L was 2.2±1.2 in the SAP and 2.6±1.0 in the ACS (p=0.002) groups. In patients with SAP, N/L was significantly correlated with Gensini and SYNTAX scores (Gensini score r=0.32, p=0.002; SYNTAX score r=0.36, p=0.000), but there was no significant correlation between N/L and MBG. In the ACS group, N/L had a more powerful association with both Gensini and SYNTAX scores (Gensini r=0.42, p=0.001; SYNTAX r=0.51, p=0.000). N/L was negatively correlated with MBG in ACS patients (r= -0.48, p=0.000). Significant correlations persisted both in the SAP and ACS groups after correcting for age, diabetes, hyperlipidemia, and statin use; however, the associations were weaker. Cut-off N/L to predict moderate to severe CAD according to SYNTAX score was 2.26, with 72% sensitivity and 71% specificity (area under the curve [AUC]: 0.772, 95% confidence interval [CI] 0.679-0.865, p<0.001).
N/L is associated with severe, extensive and complex CAD and may be used to predict moderate to severe involvement in patients with CAD.
我们研究了中性粒细胞与淋巴细胞比值（N/L）与冠状动脉疾病（CAD）的范围、严重程度和复杂性以及心肌灌注之间的关系。
本研究纳入了151例因稳定型心绞痛（SAP）（n = 93）或急性冠状动脉综合征（ACS）（n = 58）接受冠状动脉造影的患者。在冠状动脉造影前采集血样。评估Gensini评分、SYNTAX评分和心肌 blush 分级（MBG）。
SAP组和ACS组的中性粒细胞计数分别为4.4±1.4和5.0±1.6（p = 0.018），而淋巴细胞计数分别为2.2±0.7和2.1±0.7（p = 0.104）。SAP组的N/L为2.2±1.2，ACS组为2.6±1.0（p = 0.002）。在SAP患者中，N/L与Gensini评分和SYNTAX评分显著相关（Gensini评分r = 0.32，p = 0.002；SYNTAX评分r = 0.36，p = 0.000），但N/L与MBG之间无显著相关性。在ACS组中，N/L与Gensini评分和SYNTAX评分的相关性更强（Gensini r = 0.42，p = 0.001；SYNTAX r = 0.51，p = 0.000）。ACS患者中N/L与MBG呈负相关（r = -0.48，p = 0.000）。在校正年龄、糖尿病、高脂血症和他汀类药物使用后，SAP组和ACS组的显著相关性仍然存在；然而，相关性较弱。根据SYNTAX评分预测中度至重度CAD的N/L临界值为2.26，敏感性为72%，特异性为71%（曲线下面积[AUC]：0.772，95%置信区间[CI] 0.679 - 0.865，p < 0.001）。
N/L与严重、广泛和复杂的CAD相关，可用于预测CAD患者的中度至重度病变。
