摘要
目的探讨中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)和空腹血糖(fasting blood glucose,FBG)对急性心肌梗死(acute myocardial infarction,AMI)患者预后的交互作用。方法纳入诊断为AMI的患者436例,通过临床或电话联系对患者随访48(45,53)个月。分别研究NLR和FBG对心脏死亡的影响,并计算它们对心脏死亡的加性和乘性交互作用。结果随访期间,26例(6.0%)患者发生心脏死亡。NLR与FBG之间不存在乘性交互作用,但对心脏死亡有正加性交互作用。协同指数显示,同时暴露于这两种危险因素的心脏死亡风险是单独暴露于这两种危险因素的心脏死亡风险总和的5.894倍(P<0.05)。归因比显示,77.9%的心脏死亡可归因于NLR和FBG的交互作用(P<0.05),这意味着高NLR和高FBG同时存在时的影响大于它们单独存在时的影响。结论高NLR和高FBG具有积极的协同作用,为AMI患者的预后识别提供了额外的信息。
Objective To explore the interaction of neutrophil to lymphocyte ratio(NLR)and fasting blood glucose(FBG)with the prognosis of acute myocardial infarction(AMI)patients.Methods A total of 436 patients diagnosed with AMI were included.They were followed up through clinic or telephone contact for a period of 48(45,53)months.The effect of NLR and FBG on cardiac mortality was investigated respectively,and their additive and multiplicative interaction on cardiac mortality were calculated.Results During the follow-up,26 patients(6.0%)had cardiac mortality.There was no multiplicative interaction between NLR and FBG,however,the positive additive interaction on cardiac mortality was observed.The synergetic index showed that the risk of cardiac death exposed to these two risk factors at the same time was 5.894 times of the sum of the cardiac death risk exposed to either of the two risk factors alone(P<0.05).Attributable proportion showed that 77.9%of cardiac death could be attributed to the interaction between NLR and FBG(P<0.05).It indicated that the influence of concurrent high NLR and high FBG was greater than that of either of the two risk factors alone.Conclusion High NLR and high FBG have a positive synergistic effect,providing additional information for the prognosis identification of AMI patients.
作者
李宁远
胡泽平
LI Ningyuan;HU Zeping(Department of Cardiology,the First Affiliated Hospital of Anhui Medical University,Hefei Anhui 230022,China)
出处
《实用心电与临床诊疗》
2025年第1期48-56,共9页
PRACTICAL ELECTROCARDIOLOGY AND CLINICAL TREATMENT
作者简介
李宁远,主要从事心血管疾病相关研究。;通信作者:胡泽平,E-mail:3963260848@qq.com。
