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中性粒细胞与淋巴细胞比值可预测接受直接经皮冠状动脉介入治疗的ST段抬高型心肌梗死患者的造影剂诱导的急性肾损伤。

Neutrophil-to-Lymphocyte Ratio Predicts Contrast-Induced Acute Kidney Injury in Patients with ST-Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention.

作者信息

Tanık Veysel Ozan, Çınar Tufan, Velibey Yalçın, Öz Ahmet, Kalenderoğlu Koray, Gümüşdağ Ayça, Aruğaslan Emre, Keskin Muhammed, Eren Mehmet

机构信息

Department of Cardiology, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.

Department of Cardiology, Sultan Abdülhamid Han Training and Research Hospital, Health Sciences University, Istanbul, Turkey.

出版信息

J Tehran Heart Cent. 2019 Apr;14(2):59-66.

Abstract

: Development of contrast-induced acute kidney injury (CI-AKI) in patients with ST-elevation myocardial infarction (STEMI) treated via primary percutaneous coronary intervention (PCI) is a major cause of morbidity and mortality worldwide. The neutrophil-to-lymphocyte ratio (NLR), which is a marker of inflammation, has been demonstrated to be associated with the development of major adverse cardiovascular outcomes in many studies. From this point of view, in this study, we aimed to evaluate the predictive value of the NLR as regards the occurrence of CI-AKI in patients with STEMI undergoing primary PCI. : This study was conducted at Dr. Siyami Ersek Training and Research Hospital from May 2008 to June 2016. A total of 2000 patients with STEMI treated via primary PCI were enrolled in the study. The NLR was calculated as the ratio of the number of neutrophils to the number of lymphocytes. All venous blood samples were obtained within 8 hours after admission. CI-AKI was the primary end point of the study. Then, the relationship between CI-AKI and the NLR was assessed. : CI-AKI was detected in 148 (7.4%) patients. The patients who developed CI-AKI had a significantly higher NLR than those who did not (7.08±4.43 vs. 6.18±3.98; P=0.011). In the multivariate logistic regression analyses, the NLR remained a significant independent predictor of CI-AKI (OR: 1.78, 95% CI: 1.21-2.61, and P=0.003). : The NLR may be a significant independent predictor of CI-AKI in patients with STEMI treated via primary PCI and higher NLR values could be independently associated with a greater risk for CI-AKI.

摘要

经皮冠状动脉介入治疗(PCI)的ST段抬高型心肌梗死(STEMI)患者发生造影剂诱导的急性肾损伤(CI-AKI)是全球范围内发病和死亡的主要原因。中性粒细胞与淋巴细胞比值(NLR)作为一种炎症标志物,在许多研究中已被证明与主要不良心血管事件的发生有关。从这一角度出发,在本研究中,我们旨在评估NLR对接受直接PCI的STEMI患者发生CI-AKI的预测价值。 本研究于2008年5月至2016年6月在锡亚米·埃尔塞克培训与研究医院进行。共有2000例接受直接PCI治疗的STEMI患者纳入本研究。NLR计算为中性粒细胞数与淋巴细胞数之比。所有静脉血样本均在入院后8小时内采集。CI-AKI是本研究的主要终点。然后,评估CI-AKI与NLR之间的关系。 148例(7.4%)患者检测到CI-AKI。发生CI-AKI的患者NLR显著高于未发生者(7.08±4.43 vs. 6.18±3.98;P=0.011)。在多因素逻辑回归分析中,NLR仍然是CI-AKI的显著独立预测因子(OR:1.78,95%CI:1.21-2.61,P=0.003)。 NLR可能是接受直接PCI治疗的STEMI患者发生CI-AKI的显著独立预测因子,较高的NLR值可能独立于CI-AKI的更大风险相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b44c/6842023/460049d2af10/JTHC-14-59-g001.jpg

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