术前中性粒细胞与淋巴细胞比值升高与 TEVAR 治疗未合并复杂型 B 型主动脉夹层的早期不良结局相关。
Elevated preoperative neutrophil-to-lymphocyte ratio predicts early adverse outcomes in uncomplicated type B aortic dissection undergoing TEVAR.
机构信息
Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, 200433, China.
出版信息
BMC Cardiovasc Disord. 2021 Feb 16;21(1):95. doi: 10.1186/s12872-021-01904-y.
BACKGROUND
Thoracic aortic endovascular repair (TEVAR) of uncomplicated type B aortic dissection (uTBAD) has favorable long-term outcomes but higher early adverse events compared with the optimal medical treatment. Recently, clinical evidence concerning vascular surgery indicates that elevated preoperative systemic inflammatory response predicts adverse clinical events. The aim of our study was to evaluate the relationship between preoperative neutrophil-to-lymphocyte ratio (NLR) and early outcomes of uTBAD patients undergoing TEVAR.
RESULTS
216 patients diagnosed with uTBAD were included in this retrospective study between January 2015 and December 2018. The median (IQR) follow-up period was 21 (15-33) months. An early adverse event was defined as occurring within 2 years after the procedure. Median patient age was 60 (IQR, 48-68) years and 78.7 % were male. Early adverse events occurred in 24 patients (11.1 %). In the multivariable analysis, preoperative NLR (HR per SD, 1.98; 95 % CI, 1.14-3.44; P = 0.015) was associated with 2-year adverse events.
CONCLUSIONS
NLR is an independent predictive factor of early adverse events in uTBAD patients undergoing TEVAR.
背景
未经治疗的 B 型主动脉夹层（uTBAD）的胸主动脉血管内修复（TEVAR）具有良好的长期结果，但与最佳药物治疗相比，早期不良事件发生率更高。最近，有关血管外科的临床证据表明，术前全身性炎症反应升高预示着不良的临床事件。我们的研究目的是评估 uTBAD 患者行 TEVAR 术前中性粒细胞与淋巴细胞比值（NLR）与早期结局的关系。
结果
本回顾性研究纳入了 2015 年 1 月至 2018 年 12 月间诊断为 uTBAD 的 216 例患者。中位（IQR）随访时间为 21（15-33）个月。早期不良事件定义为术后 2 年内发生。患者中位年龄为 60（IQR，48-68）岁，78.7%为男性。24 例患者（11.1%）发生早期不良事件。多变量分析显示，术前 NLR（每 SD 的 HR，1.98；95%CI，1.14-3.44；P=0.015）与 2 年不良事件相关。
结论
NLR 是 uTBAD 患者行 TEVAR 后早期不良事件的独立预测因素。
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