Department of Cardiovascular Surgery, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey.
Eur Rev Med Pharmacol Sci. 2016 Mar;20(5):906-11.
Post-pericardiotomy syndrome (PPS) occurs in 10-40% of patients after cardiac surgery. PPS is considered an autoimmune phenomenon. The neutrophil-to-lymphocyte ratio (NLR) is a novel inflammatory marker that is associated with various cardiovascular diseases. Studies have reported that the NLR increases in certain autoimmune diseases. This study examined whether the NLR is helpful to predict the occurrence of PPS after elective on-pump coronary artery bypass graft (CABG) surgery.
The records of patients who underwent elective first-time on-pump CABG were reviewed retrospectively. In total, 72 patients with PPS were included in the study, and 100 patients who did not develop PPS were included as the control group. Peripheral blood samples collected preoperatively and on postoperative day 1 were used to calculate the NLR.
No differences in preoperative white blood cell (WBC) count, neutrophil count, lymphocyte count, or NLR were observed between the patients with PPS and the control group. The WBC (p < 0.001) and neutrophil counts (p < 0.001) and NLR (p = 0.01) were significantly higher during the postoperative period in patients with PPS than in the control group. A receiver operating characteristic curve analysis showed that the postoperative NLR predicted PPS with 60% sensitivity and 59% specificity (area under the curve, 0.61; 95% confidence interval [CI], 0.51-0.70; p = 0.017), using a cut-off of 8.34. The postoperative WBC count (odds ratio [OR], 1.6; 95% CI, 1.36-2.03; p < 0.001) and NLR (OR, 3.3; 95% CI, 1.56-7.01; p = 0.002) were independently associated with PPS.
The postoperative NLR may be useful to predict the development of PPS in patients undergoing on-pump CABG.
心包切开后综合征（PPS）在心脏手术后 10-40%的患者中发生。PPS 被认为是一种自身免疫现象。中性粒细胞与淋巴细胞比值（NLR）是一种新的炎症标志物，与各种心血管疾病相关。研究报告称，NLR 在某些自身免疫性疾病中增加。本研究旨在探讨 NLR 是否有助于预测择期体外循环冠状动脉旁路移植术（CABG）后 PPS 的发生。
回顾性分析接受择期首次体外循环 CABG 的患者记录。共纳入 72 例 PPS 患者为研究组，另纳入 100 例未发生 PPS 的患者为对照组。收集术前和术后第 1 天的外周血样，计算 NLR。
PPS 患者与对照组患者术前白细胞计数（WBC）、中性粒细胞计数、淋巴细胞计数或 NLR 无差异。与对照组相比，PPS 患者术后 WBC（p < 0.001）和中性粒细胞计数（p < 0.001）及 NLR（p = 0.01）均显著升高。受试者工作特征曲线分析显示，术后 NLR 预测 PPS 的敏感性为 60%，特异性为 59%（曲线下面积，0.61；95%置信区间 [CI]，0.51-0.70；p = 0.017），截断值为 8.34。术后 WBC 计数（比值比 [OR]，1.6；95% CI，1.36-2.03；p < 0.001）和 NLR（OR，3.3；95% CI，1.56-7.01；p = 0.002）与 PPS 独立相关。
术后 NLR 可能有助于预测体外循环 CABG 患者 PPS 的发生。
