摘要
目的 探讨中性粒细胞与淋巴细胞比值(NLR)、D-二聚体(D-D)、白细胞介素(IL)-6、干扰素(IFN)-γ对急性StanfordB型主动脉夹层(AADB)患者院内死亡风险的预测效能.方法 根据院内终点事件发生情况,将86例AADB患者分为存活组71例和死亡组15例,比较两组患者NLR、D-D、IL-6、IFN-γ水平.采用Cox回归分析评估AADB患者院内死亡的影响因素;采用受试者工作特征(ROC)曲线分析NLR、D-D、IL-6、IFN-γ对AADB患者院内死亡的预测效能;采用相对风险值(RR)分析NLR、D-D、IL-6、IFN-γ阳性表达对AADB患者院内死亡风险的影响.结果 死亡组患者NLR、D-D、IL-6、IFN-γ水平均高于存活组(P＜0.05).Cox回归分析结果显示,NLR、D-D、IL-6、IFN-γ均为AADB患者院内死亡的独立危险因素(P＜0.001).NLR、D-D、IL-6、IFN-γ4者联合对AADB患者院内死亡的预测效能优于单项指标.NLR、D-D、IL-6、IFN-γ阳性表达AADB患者院内死亡率均高于对应指标阴性表达患者(P＜0.001).RR分析结果显示,NLR、D-D、IL-6、IFN-γ阳性表达均显著增加AADB患者的院内死亡风险(P＜0.001).结论 NLR、D-D、IL-6、IFN-γ是AADB患者院内死亡的独立预测因子,4者联合具有可靠的预测效能.
Abstract
Objective To investigate the predictive efficacy of neutrophil to lymphocyte ratio(NLR),D-dimer(D-D),interleukin(IL)-6 and interferon(IFN)-γ on risk of in-hospital death in patients with acute Stanford type B aortic dissection(AADB).Methods A total of 86 patients with AADB were divided into survival group(71 cases)and death group(15 cases)according to occurrence of end-point events in hospital.NLR,D-D,IL-6 and IFN-γ levels between two groups were compared.Cox regression analysis was used to analyze influencing factors for in-hospital death in patients with AADB.Receiver operating characteristic(ROC)curve was used to analyze predictive efficacy of NLR,D-D,IL-6 and IFN-γon in-hospital death in patients with AADB.Relative risk value was used to analyze effect of positive expressions of NLR,D-D,IL-6 and IFN-γ on risk of in-hospital death in patients with AADB.Results NLR,D-D,IL-6 and IFN-γ levels in patients of death group were higher than those in survival group(P＜0.05).Cox regression analysis result showed that NLR,D-D,IL-6 and IFN-γ were all independent risk factors for in-hospital death in patients with AADB(P＜0.001).The combined efficacy of NLR,D-D,IL-6,and IFN-γ in predicting in-hospital death in patients with AADB was superior to single indicators.In-hospital mortality of patients with AADB with positive expression of NLR,D-D,IL-6 and IFN-γ were all higher than those of patients with negative expression of corresponding index(P＜0.001).Risk value analysis showed that positive expression of NLR,D-D,IL-6 and IFN-γ all significantly increased risk of in-hospital death in patients with AADB(P＜0.001).Conclusion NLR,D-D,IL-6,IFN-γ are independent predictors of in-hospital death in patients with AADB,combination of above 4 index has reliable predictive efficacy.
基金项目
聊城市重点研发计划政策引导类项目(2023YD45)
NETL
NSTL
万方数据