摘要
目的探究中性粒细胞/淋巴细胞比值(NLR)与高血压患者左心室舒张功能不全的关系。方法选取2013年1月—2015年10月在中山市小榄人民医院心血管内科住院的高血压患者46例,根据是否合并左心室舒张功能不全分为对照组(未合并左心室舒张功能不全,n=30)和观察组(合并左心室舒张功能不全,n=16)。比较两组患者实验室检查指标〔包括低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)、纤维蛋白原(FIB)及C反应蛋白(CRP)〕及超声心动图检查结果〔包括左心室射血分数(LVEF)、左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESd)、室间隔厚度(IVS)、左心室后壁厚度(LVPW)、舒张早期E峰峰速/舒张晚期A峰峰速(E/A)比值、E峰减速时间(EDT)、左房室瓣舒张早期血流峰速度/左房室瓣环舒张早期运动峰速度(E/Ea)〕,比较不同左心室舒张功能不全分级患者NLR、E/A比值、E/Ea及EDT,并分析NLR与E/A比值、E/Ea及EDT的相关性。结果观察组患者HDL-C和TG水平低于对照组(P<0.05);两组患者LDL-C、FIB、CRP水平比较,差异均无统计学意义(P>0.05)。两组患者LVEF、LVEDd及LVESd比较,差异无统计学意义(P>0.05);观察组患者IVS、LVPW、E/Ea及NLR大于对照组,EDT短于对照组,E/A比值小于对照组(P<0.05)。根据左心室舒张功能不全分级标准将观察组患者分为Ⅰ级9例,Ⅱ级4例,Ⅲ级3例。Ⅲ级患者NLR、E/A比值、E/Ea大于Ⅰ级和Ⅱ级患者,EDT短于Ⅰ级和Ⅱ级患者(P<0.05);Ⅱ级患者NLR、E/A比值、E/Ea大于Ⅰ级患者,EDT短于Ⅰ级患者(P<0.05)。Pearson直线相关性分析结果显示,NLR与E/A比值(r=0.395,P<0.05)、E/Ea(r=0.419,P<0.05)呈正相关,与EDT呈负相关(r=-0.17,P<0.05)。结论 NLR与高血压患者左心室舒张功能不全严重程度有关,可作为高血压患者左心室舒张功能不全的预测指标。
Objective To investigate the relationship between neutrophils/ lymphocyte ratio （ NLR ） and left ventricular diastolic dysfunction of patients with hypertension. Methods From January 2013 to October 2015 in the Department of Cardiology,Xiaolan People＇s Hospital of Zhongshan,a total of 46 patients with hypertension were selected,and they were divided into control group（ did not complicated with left ventricular diastolic dysfunction,n = 30） and observation group （complicated with left ventricular diastolic dysfunction,n = 16）. Laboratory examination results（including LDL-C,HDL-C, TG FIB and CRP）and echocardiography examination results（including LVEF,LVEDd,LVESd,IVS,LVPW,E/ A ratio, EDT and E/ Ea）were compared between the two groups;NLR,E/ A ratio,E/ Ea,and EDT were compared in hypertension patients with different grades of left ventricular diastolic dysfunction,and correlation between NLR and E/ A ratio,and E/ Ea and EDT was respectively analyzed. Results HDL-C and TG of observation group were statistically significantly lower than those of control group（P ﹤ 0. 05）,while no statistically significant differences of LDL-C,FIB or CRP was found between the two groups （P ﹥ 0. 05）. No statistically significant differences of LVEF,LVEDd or LVESd was found between the two groups（P ﹥ 0. 05）;IVS,LVPW,E/ Ea and NLR of observation group were statistically significantly larger than those of control group,EDT of observation group was statistically significantly shorter than that of control group,while E/ A ratio of observation group was statistically significantly smaller than that of control group（ P ﹤ 0. 05）. According to the grades of left ventricular diastolic dysfunction,patients of observation groups were divided into three subgroups：A group（with Ⅰ - grade left ventricular diastolic dysfunction,n = 9）,B group（with Ⅱ - grade left ventricular diastolic dysfunction,n = 4）and C group（with Ⅲ - grade left ventricular diastolic dysfunction,n = 3）. NLR,E/ A ratio and E/ Ea of C group were statistically significantly larger than those of A group and B group,while EDT of observation group was statistically significantly shorter than that of A group and B group, respectively（P ﹤ 0. 05）;NLR,E/ A ratio and E/ Ea of B group were statistically significantly larger than those of A group, while EDT of B group was statistically significantly shorter than that of A group（P ﹤ 0. 05）. Pearson linear correlation analysis showed that,NLR was positively correlated with E/ A ratio（ r = 0. 395,P ﹤ 0. 05）,with E/ Ea（ r = 0. 419,P ﹤ 0. 05）, respectively,was negatively correlated with EDT（r = - 0. 17,P ﹤ 0. 05）. Conclusion NLR is correlated with left ventricular diastolic dysfunction of patients with hypertension,can be used as predictive index of left ventricular diastolic dysfunction of patients with hypertension.
作者
黄南和
林润杰
孔倩文
谭志发
HUANG Nan-he LIN Run-jie KONG Qian-wen TAN Zhi-fa(Department of Cardiology, Xiaolan People＇s Hospital of Zhongshan, Zhongshan 528400, Chin)
出处
《实用心脑肺血管病杂志》
2016年第6期19-22,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
