摘要
目的 探讨中性粒细胞和淋巴细胞比值(NLR)及尿酸(UA)与非瓣膜性心房颤动(NVAF)合并颈动脉粥样硬化(CAS)的相关性.方法 选择 2018年 2月～2020年 8月芜湖市第二人民医院心内科收治的 98例NVAF患者,根据颈动脉彩超结果分为硬化组(n=56)和无硬化组(n=42),另选同期窦性心律无房颤病史体检者40例作为对照组.随访 2年,记录心血管事件.比较 3组UA、NLR水平、左心室质量指数(LVMI)、心血管事件发生率差异.分析UA、NLR与LVMI相关性及NVAF合并CAS发生心血管事件危险因素.结果 硬化组UA、NLR水平、LVMI值均高于无硬化组和对照组(均P<0.01),无硬化组UA、NLR水平及LVMI值均高于对照组(均P<0.01).Pearson分析显示,UA、NLR与LVMI呈正相关(r=0.438、r=0.379,P<0.01).硬化组心血管事件发生率高于无硬化组(P<0.05)和对照组(P<0.01),无硬化组心血管事件发生率高于对照组(P<0.05).多因素Logistic回归分析显示,CHA2DS2-VASc评分、UA、NLR、左房内径(LAD)是NVAF合并CAS发生心血管事件独立危险因素.结论 NVAF合并CAS患者UA、NLR水平升高与心肌重构和心血管事件发生率相关,可能对临床治疗提供依据.
Abstract
AIM To study the pertinence of uric acid(UA)and neutrophil to lymphocyte ratio(NLR)in nonvalvular atrial fibrillation(NVAF)patients with carotid atherosclerosis(CAS).METHODS A total of 98 NVAF patients admitted to our department from February 2018 to August 2020 were selected.According to the results of carotid ultrasound,they were divided into sclerotic group(n=56)and non-sclerotic group(n=42).Another 40 patients with sinus rhythm and no history of atrial fibrillation were selected as control group.After 2 years of follow-up,cardiovascular events were recorded.The levels of UA,NLR,left ventricular mass index(LVMI),and incidence of cardiovascular events were compared in the three groups.To analyze the pertinence of UA,NLR and LVMI and the risk factors of cardiovascular events in NVAF with CAS.RESULTS The UA,NLR levels,and LVMI values in the sclerotic group were higher than those in the non sclerotic group and the control group(all P<0.01),while the UA,NLR levels,and LVMI values in the non sclerotic group were higher than those in the control group(all P<0.01).Pearson analysis showed a positive correlation between UA,NLR,and LVMI(r=0.438,r=0.379,P<0.01).The incidence of cardiovascular events in the sclerosis group was higher than that in the non sclerosis group(P<0.05)and the control group(P<0.01),while the incidence of cardiovascular events in the non sclerosis group was higher than that in the control group(P<0.05).Multivariate logistic regression analysis showed that CHA2DS2-VASc score,UA,NLR,and left atrial diameter(LAD)were independent risk factors for cardiovascular events in NVAF combined with CAS.CONCLUSION The increased levels of UA and NLR in NVAF patients with CAS are associated with myocardial remodeling and the incidence of cardiovascular events,which may provide a basis for clinical treatment.
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