Onuk Tolga, Güngör Bariş, Karataş Baran, Ipek Göktürk, Akyüz Sükrü, Ozcan Kazim Serhan, Uğur Sinem Yiğit, Onuk Burak Emre, Yelgeç Nizamettin Selçuk, Kaşikçioğlu Hülya, Cam Neşe
Clin Lab. 2015;61(9):1275-82.
i ne prognostic relevance of hematological parameters in cardiovascular diseases has been well demonstrated. The purpose of the present study is to investigate the association between the hematological parameters, particularly neutrophil to lymphocyte ratio (NLR), and outcomes of aortic dissection (AD).
Two hundred patients diagnosed with AD were retrospectively recruited and compared with 76 subjects with ascending aortic dilatation (AAD) and 92 subjects with normal aortic diameters. The independent relation between hematological parameters and in-hospital mortality was analyzed by regression analysis.
The NLR was significantly higher in the AD group compared to the AAD and control groups (median 8.83 [8.13] vs. median 1.95 [1.10] vs. median 1.71 [0.77], respectively; p = 0.01). The NLR was higher in the deceased (n = 57) compared to the surviving patients (n = 143) (median 10.37 [10.86] vs. median 7.84 [8.17]; p = 0.01). Receiver operating curve (ROC) analysis revealed that a NLR measurement higher than > 8.78 predicted in-hospital mortality for patients with acute aortic dissection with a sensitivity of 67.4% and a specificity of 57.2% (AUC: 0.672; p = 0.01). In multivariate logistic regression analysis, increased aortic diameter, acute dissection, and increased levels of NLR remained as the independent markers of in-hospital mortality within the study population.
In patients with AD, NLR levels were increased compared to patients with AAD and controls and were independently associated with in-hospital mortality. This finding implicates that admission hematological parameters may have clinical importance in evaluating the mortality risk in patients with AD.
血液学参数在心血管疾病中的预后相关性已得到充分证实。本研究的目的是探讨血液学参数，特别是中性粒细胞与淋巴细胞比值（NLR）与主动脉夹层（AD）预后之间的关系。
回顾性招募了200例诊断为AD的患者，并与76例升主动脉扩张（AAD）患者和92例主动脉直径正常的受试者进行比较。通过回归分析分析血液学参数与院内死亡率之间的独立关系。
与AAD组和对照组相比，AD组的NLR显著更高（中位数分别为8.83[8.13]、1.95[1.10]和1.71[0.77]；p=0.01）。与存活患者（n=143）相比，死亡患者（n=57）的NLR更高（中位数分别为10.37[10.86]和7.84[8.17]；p=0.01）。受试者工作曲线（ROC）分析显示，NLR测量值高于8.78可预测急性主动脉夹层患者的院内死亡率，敏感性为67.4%，特异性为57.2%（AUC：0.672；p=0.01）。在多因素逻辑回归分析中，主动脉直径增加、急性夹层和NLR水平升高仍是研究人群院内死亡率的独立标志物。
与AAD患者和对照组相比，AD患者的NLR水平升高，且与院内死亡率独立相关。这一发现表明，入院时的血液学参数在评估AD患者的死亡风险方面可能具有临床重要性。
