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在一项病例对照研究中,淋巴细胞与单核细胞比值与狭窄后主动脉严重扩张相关。

Lymphocyte-to-monocyte ratio associated with severe post-stenotic aortic dilation in a case-control study.

机构信息

Department of Cardiovascular Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No.324 Jingwu Road, Jinan, 250021, Shandong, China.

Department of Cardiovascular Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324 Jingwu Road, Jinan, 250021, Shandong, China.

出版信息

BMC Cardiovasc Disord. 2022 Apr 26;22(1):195. doi: 10.1186/s12872-022-02636-3.

Abstract

BACKGROUND

Calcific aortic valve stenosis (CAVS) represents a serious health threat to elderly patients. Post-stenotic aortic dilation, a common feature in CAVS patients, might progress into aneurysm and even dissection, potential consequences of CAVS, and predicts a poor prognosis. This study sought to investigate the association of lymphocyte-to-monocyte ratio (LMR), an inflammatory biomarker, with severe post-stenotic aortic dilation in a case-control study in Chinese population.

MATERIALS AND METHODS

208 consecutive patients with CAVS were recruited retrospectively in a case-control study in Chinese population, from July 1, 2015 to June 31, 2018. LMR was statistically analyzed using the ROC curve and binary logistic regression analyses for its prognostic value in severe post-stenotic aortic dilation.

RESULTS

LMR was significantly reduced in patients with severe post-stenotic aortic dilation (2.72 vs. 3.53, p = 0.002 < 0.05) compared to patients without severe post-stenotic aortic dilation. There was an inverse correlation observed between the maximal diameter of ascending aorta and LMR in the overall patients (r = - 0.217, p = 0.002 < 0.05). For post-stenotic aortic dilation, the prevalence of high-LMR group was statistically lower than that of low-LMR group (19.7% vs. 43.9%, p < 0.001). The maximal diameter of ascending aorta was significantly reduced in the high-LMR group (4.35 vs. 4.76, p = 0.003 < 0.05) compared to low-LMR group. Additionally, LMR was identified in the multivariate analysis independently associated with severe post-stenotic aortic dilation (AUC 0.743, 95% CI: [0.573-0.964], p = 0.025).

CONCLUSIONS

This study provided the evidence of an inverse correlation between severe post-stenotic aortic dilation and LMR. LMR is potentially independently associated with severe post-stenotic aortic dilation.

摘要

背景

钙化性主动脉瓣狭窄(CAVS)是老年患者的严重健康威胁。后狭窄主动脉扩张是 CAVS 患者的常见特征,可能进展为动脉瘤,甚至夹层,这是 CAVS 的潜在后果,并预示预后不良。本研究旨在探讨炎症标志物淋巴细胞与单核细胞比值(LMR)与中国人群 CAVS 患者严重后狭窄主动脉扩张的相关性。

材料与方法

2015 年 7 月 1 日至 2018 年 6 月 31 日,采用回顾性病例对照研究,连续纳入 208 例 CAVS 患者。使用 ROC 曲线和二元逻辑回归分析对 LMR 在严重后狭窄主动脉扩张中的预后价值进行统计学分析。

结果

与无严重后狭窄主动脉扩张的患者相比,严重后狭窄主动脉扩张患者的 LMR 明显降低(2.72 与 3.53,p=0.002<0.05)。在所有患者中,升主动脉最大直径与 LMR 呈负相关(r=-0.217,p=0.002<0.05)。在后狭窄主动脉扩张中,高 LMR 组的患病率明显低于低 LMR 组(19.7%比 43.9%,p<0.001)。与低 LMR 组相比,高 LMR 组的升主动脉最大直径明显减小(4.35 与 4.76,p=0.003<0.05)。此外,多因素分析显示 LMR 与严重后狭窄主动脉扩张独立相关(AUC 0.743,95%CI:[0.573-0.964],p=0.025)。

结论

本研究提供了严重后狭窄主动脉扩张与 LMR 之间存在负相关的证据。LMR 可能与严重后狭窄主动脉扩张独立相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a1/9044758/69a237490dd8/12872_2022_2636_Fig1_HTML.jpg

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