中性粒细胞与淋巴细胞比值及平均血小板体积可能与急性风湿性心脏炎患者瓣膜受累的严重程度相关。
The neutrophil-to-lymphocyte ratio and mean platelet volume can be associated with severity of valvular involvement in patients with acute rheumatic carditis.
作者信息
Çelik Serkan F, Çelik Elif
机构信息
Division of Paediatric Cardiology, Department of Paediatrics, Adnan Menderes University Hospital, Aydin, Turkey. Email:
Department of Paediatrics, Adnan Menderes University Hospital, Aydin, Turkey.
出版信息
Cardiovasc J Afr. 2018;29(5):296-300. doi: 10.5830/CVJA-2018-031. Epub 2018 Sep 10.
OBJECTIVE
The aim of the study was to investigate the association between the severity of acute rheumatic carditis (ARC) and the neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV).
METHODS
Paediatric patients diagnosed with ARC between 2010 and 2016 and age- and gender-matched controls were retrospectively analysed. At the time of diagnosis, we reviewed the demographic features obtained: echocardiographic data, complete blood count reports, acute-phase reactants, including C-reactive protein, and erythrocyte sedimentation rate values. The patient group was further divided into two subgroups according to the degree of valvular regurgitation, which included those with severe and those with mild-to-moderate valvular regurgitation.
RESULTS
The number of cases with ARC and age- and gender-matched controls were 120 and 50, respectively. The mean age of the patients was 12.25 ± 2.89 (range: 7-18) years. NLR, MPV, anti-streptolysin-O, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), haemoglobin level, and white blood cell (WBC) and neutrophil count were significantly higher in patients with acute carditis compared with the controls ( < 0.001). NLR was found to have a significantly positive correlation with CRP ( = 0.177, = 0.001), ESR (r = 0.81, = 0.03) and WBC count ( = 0.47, = 0.001). Moreover, we found a positive correlation between NLR and severity of valvular regurgitation (r = 0.34, < 0.001), and a negative correlation between MPV and severity of valvular regurgitation ( = -0.38, < 0.05) in our patients. In multiple linear regression analysis, severe valvular regurgitation was associated with NLR (0.51; 95% CI: 0.32-0.68; = 0.006) and MPV ( -0.78; 95% CI: -0.72 to -0.98; = 0.008).
CONCLUSIONS
NLR and MPV are novel inflammatory markers and simple, rapid and easily accessible prognostic parameters that can be associated with severity of valvular involvement in patients with ARC.
目的
本研究旨在探讨急性风湿性心脏炎（ARC）的严重程度与中性粒细胞与淋巴细胞比值（NLR）及平均血小板体积（MPV）之间的关联。
方法
对2010年至2016年间诊断为ARC的儿科患者以及年龄和性别匹配的对照组进行回顾性分析。在诊断时，我们查阅了所获得的人口统计学特征：超声心动图数据、全血细胞计数报告、急性期反应物（包括C反应蛋白）以及红细胞沉降率值。根据瓣膜反流程度，将患者组进一步分为两个亚组，即重度瓣膜反流组和轻度至中度瓣膜反流组。
结果
ARC患者及年龄和性别匹配的对照组人数分别为120例和50例。患者的平均年龄为12.25±2.89（范围：7 - 18）岁。与对照组相比，急性心脏炎患者的NLR、MPV、抗链球菌溶血素O、C反应蛋白（CRP）、红细胞沉降率（ESR）、血红蛋白水平以及白细胞（WBC）和中性粒细胞计数均显著更高（<0.001）。发现NLR与CRP（=0.177，=0.001）、ESR（r = 0.81，=0.03）和WBC计数（=0.47，=0.001）呈显著正相关。此外，在我们的患者中，发现NLR与瓣膜反流严重程度呈正相关（r = 0.34，<0.001），而MPV与瓣膜反流严重程度呈负相关（=-0.38，<0.05）。在多元线性回归分析中，重度瓣膜反流与NLR（0.51；95%置信区间：0.32 - 0.68；=0.006）和MPV（-0.78；95%置信区间：-0.72至-0.98；=0.008）相关。
结论
NLR和MPV是新型炎症标志物，也是简单、快速且易于获取的预后参数，可与ARC患者的瓣膜受累严重程度相关联。
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