摘要
目的 观察非动脉炎性视网膜中央动脉阻塞(NA-CRAO)患者外周血中部分与炎症相关的血细胞变化.方法 回顾性临床研究.2019年7月至2021年7月于西安市人民医院(西安市第四医院)眼科住院治疗的NA-CRAO患者218例(NA-CRAO组)及同期常规体检者218名(对照组)纳入研究.两组受检者年龄(t=0.60)、性别构成比(x2=0.83)、体重指数(t=0.77)比较,差异均无统计学意义(P＞0.05).采集受检者空腹外周静脉血0.2 ml,检测白细胞(WBC)、中性粒细胞(NEUT)、淋巴细胞(LYMPH)、红细胞(RBC)、RBC分布宽度(RDW)、血小板(PLT)、平均PLT体积(MPV)、大PLT比率(PLCR),计算NEUT/LYMPH比率(NLR)、PLT/LYMPH比率(PLR).组间计量资料比较采用t检验.对P＜0.05的血细胞行多因素logistic回归分析.采用受试者工作特征曲线(ROC曲线)计算各炎症指标的曲线下面积(AUC)及其95％可信区间(95％CI),根据约登指数(灵敏度+特异性-1)确定最佳临界值.结果 与对照组比较,NA-CRAO组患者WBC、NEUT、NLR、RDW、PLR升高,LYMPH、RBC降低,差异均有统计学意义(t=-9.68、12.43、9.47、3.64、5.54、5.18、0.46,P＜0.001);两组PLT、MPV、PLCR比较,差异无统计学意义(t=0.32、1.56、0.84,P＞0.05).多因素logistic回归分析结果显示,NLR是NA-CRAO发生的可能危险因素(比值比=2.51,95％CI0.780～0.859,P=0.031).ROC曲线分析结果显示,NLR预测NA-CRAO的AUC为0.819,最佳临界值为3.05,灵敏度、特异性分别为59.2％、92.7％.结论 NA-CRAO患者外周血细胞中NEUT明显升高,LYMPH减少;NLR是NA-CRAO发生的可能危险因素.
Abstract
Objectives To explore the changes of some peripheral blood cells related to inflammation in patients with non-arteritis central retinal artery occlusion(NA-CRAO).Methods A retrospective clinical study.From July 2019 to July 2021,a total of 218 patients with NA-CRAO hospitalized(NA-CRAO group)in Department of Ophthalmology,Xi'an People's Hospital(Xi'an Fourth Hospital)and 218 patients with routine physical examination(control group)during the same period were included in the study.There were no significant differences in age(t=0.60),sex composition ratio(x3=0.83)and body mass index(t=0.77)between the two groups(P＞0.05).0.2 ml fasting peripheral blood was collected from the subject,and white blood cells(WBC),neutrophils(NEUT),lymphocytes(LYMPH),red blood cells(RBC),RBC distribution width(RDW),platelets(PLT),mean PLT volume(MPV),and large PLT ratio(PLCR)were detected.The NEUT/LYMPH ratio(NLR)and PLT/LYMPH ratio(PLR)were calculated.t test was used to compare measurement data between groups.Multiple logistic regression analysis was performed for blood cells with P＜0.05.The receiver operating characteristic curve(ROC curve)was used to calculate the area under the curve(AUC)and 95％confidence interval(95％CI)of each inflammatory indicator,and the optimal cutoff value was determined according to the Jorden index(sensitivity+specificity-1).Results Compared with control group,WBC,NEUT,NLR,RDW,PLR were increased in NA-CRAO group,while RBC and LYMPH were decreased,with statistical significance(t=9.68,12.43,9.47,3.64,5.54,5.18,0.46;P＜0.001).There was no significant difference in PLT,MPV and PLCR between the two groups(t=0.32,1.56,0.84;P＞0.05).Multivariate logistic regression analysis showed that NLR was a possible risk factor for the occurrence of NA-CRAO(odds ratio=2.51,95％CI 0.780-0.859,P=0.031).ROC curve analysis showed that the AUC predicted by NLR was 0.819,the optimal critical value was 3.05,and the sensitivity and specificity were 59.2％and 92.7％,respectively.Conclusions In peripheral blood cells of NA-CRAO patients,NEUT is significantly increased and LYMPH is decreased.NLR is a possible risk factor for NA-CRAO.
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