术后中性粒细胞与淋巴细胞比值作为非体外循环冠状动脉搭桥术总体死亡率的中期预后因素
Postoperative Neutrophil to Lymphocyte Ratio as an Overall Mortality Midterm Prognostic Factor following OPCAB Procedures.
作者信息
Urbanowicz Tomasz, Michalak Michał, Gąsecka Aleksandra, Perek Bartłomiej, Rodzki Michał, Bociański Michał, Straburzyńska-Migaj Ewa, Jemielity Marek
机构信息
Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, 61-848 Poznan, Poland.
Department of Computer Science and Statistics, Poznan University of Medical Sciences, 60-806 Poznan, Poland.
出版信息
Clin Pract. 2021 Sep 3;11(3):587-597. doi: 10.3390/clinpract11030074.
BACKGROUND
Off-pump coronary artery bypass grafting (OPCAB) is believed to limit inflammatory reaction. Neutrophil to lymphocyte ratio (NLR) is one of the more common and easily accessible markers of inflammatory response. The aim of the study was to compare postoperative results of NLR with mid-term OPCAB results.
METHODS
In total, 224 patients (198 (88%) men and 26 (12%) women) with mean age 65 +/- 9 years who underwent OPCAB though median full sternotomy in our department in 2018 enrolled into the study. We scrupulously collected the postoperative mid-term results, including survival rate, clinical status and risk for major adverse events, and compared them with perioperative laboratory results.
RESULTS
A three-year follow-up was completed by 198 individuals (90% survival rate) with 12 (5%) showing major adverse cardiovascular (MACE) events risk. In the multivariable analysis, the laboratory parameters noticed on the 1st postoperative day were statistically significantly predictive of survival, including neutrophils (HR 1.59, 1.33-1.89 95%CI, < 0.0001), platelets (HR 1.01, 1.01-1.01 95%CI, = 0.0065), NLR (HR 1.47, 1.3-1.65 95%CI, < 0.0001) and postoperative ejection fraction (HR 0.9, 0.87-0.95 95%CI, < 0.0001).
CONCLUSIONS
Postoperative NLR above 4.6, as an inflammatory reaction marker, is related to mid-term mortality in OPCAB patients.
背景
非体外循环冠状动脉旁路移植术（OPCAB）被认为可限制炎症反应。中性粒细胞与淋巴细胞比值（NLR）是炎症反应较常见且易于获取的标志物之一。本研究的目的是比较NLR的术后结果与OPCAB中期结果。
方法
2018年在我们科室通过正中全胸骨切开术接受OPCAB的224例患者（198例（88%）男性和26例（12%）女性）纳入研究，平均年龄65±9岁。我们精心收集了术后中期结果，包括生存率、临床状况和主要不良事件风险，并将其与围手术期实验室结果进行比较。
结果
198例患者（生存率90%）完成了三年随访，其中12例（5%）有主要不良心血管（MACE）事件风险。在多变量分析中，术后第1天观察到的实验室参数在统计学上显著预测生存率，包括中性粒细胞（HR 1.59，95%CI 1.33 - 1.89，<0.0001）、血小板（HR 1.01，95%CI 1.01 - 1.01，=0.0065）、NLR（HR 1.47，95%CI 1.3 - 1.65，<0.0001）和术后射血分数（HR 0.9，95%CI 0.87 - 0.95，<0.0001）。
结论
术后NLR高于4.6作为炎症反应标志物，与OPCAB患者的中期死亡率相关。
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