中性粒细胞与淋巴细胞比值升高与肺移植后长期生存不良和移植物失功相关。
Elevated neutrophil to lymphocyte ratio is associated with poor long-term survival and graft failure after lung transplantation.
机构信息
Division of Thoracic Surgery, Department of Surgery, Johns Hopkins University School of Medicine, USA.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, USA.
出版信息
Am J Surg. 2021 Apr;221(4):731-736. doi: 10.1016/j.amjsurg.2020.04.007. Epub 2020 Apr 18.
PURPOSE
We aimed to assess the prognostic value of Neutrophil to Lymphocyte Ratio (NLR) on long-term outcomes and graft dysfunction after lung transplantation.
METHODS
We retrospectively reviewed all patients receiving a lung transplant at our institution from 2011 to 2014. The primary exposure was elevated NLR at the time of transplant, defined by NLR>4. The primary outcomes were graft failure and three-year all-cause mortality. Multivariate logistic regression and Kaplan-Meier survival analysis were used to analyze outcomes.
RESULTS
95 patients were included. 40 patients (42%) had an elevated NLR. Elevated NLR was associated with graft failure (OR: 4.7 [1.2-18.8], p = 0.02), and three-year mortality (OR: 5.4 [1.3-23.2], p = 0.03) on multivariate logistic regression. Patients with elevated NLR demonstrated significantly lower survival on Kaplan-Meier analysis (50% versus 74%, p = 0.02). The c-statistic for our multivariate model was 0.91.
CONCLUSION
Elevated neutrophil to lymphocyte ratio is associated with poor long-term survival and graft failure after lung transplantation.
目的
我们旨在评估中性粒细胞与淋巴细胞比值（NLR）对肺移植后长期预后和移植物功能障碍的预测价值。
方法
我们回顾性分析了 2011 年至 2014 年在我院接受肺移植的所有患者。主要暴露因素为移植时 NLR 升高，定义为 NLR>4。主要结局为移植物失功和 3 年全因死亡率。采用多变量逻辑回归和 Kaplan-Meier 生存分析来分析结果。
结果
共纳入 95 例患者，其中 40 例（42%）NLR 升高。多变量逻辑回归分析显示，NLR 升高与移植物失功（OR：4.7 [1.2-18.8]，p=0.02）和 3 年死亡率（OR：5.4 [1.3-23.2]，p=0.02）相关。Kaplan-Meier 生存分析显示，NLR 升高组患者的生存率显著降低（50%对 74%，p=0.02）。我们的多变量模型的 C 统计量为 0.91。
结论
中性粒细胞与淋巴细胞比值升高与肺移植后长期生存率和移植物失功相关。
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