Neutrophil-to-lymphocyte Ratio and 5-year All-cause Mortality in Patients with Heart Failure

doi:10.12114/j.issn.1007-9572.2019.00.632

Abstract

Abstract: Background　The mortality rate of heart failure（HF） remains high.And there are limited clinical studies on the relationship between neutrophil-to-lymphocyte ratio（NLR） and 5-year all-cause mortality in such patients.Objective　To investigate the correlation between NLR and 5-year all-cause mortality in patients with HF.Methods　This study was a single-center retrospective study.418 adult patients with symptomatic HF（NYHA class Ⅲ-Ⅳ） hospitalized in the First Affiliated Hospital of Guangxi Medical University from August，2012 to July，2013 were enrolled.Clinical data and telephone-based follow-up results were collected to understand the 5-year all-cause mortality.The relationship between NLR and 5-year all-cause mortality was analyzed across quartile subgroups stratified by NLR value.Results　The 5-year all-cause mortality in the participants was 55.3%（231/418）．Univariate analysis showed that urea，creatinine，cystatin C，creatine kinase isozyme，plasma N-terminal B-type natriuretic peptide precursor，higher NYHA classes，and elevated NLR increased the risk of 5-year all-cause mortality in HF patients（P<0.05），whereas high weight and triglyceride，the use of β receptor blockers，and women decreased the risk（P<0.05）．After adjusting for other covariates，NLR remained an independent predictor of 5-year all-cause mortality（P<0.05）．Conclusion　NLR is an independent predictor of 5-year all-cause mortality in HF patients.The higher the ratio，the higher the risk.

Key words: Heart failure, Neutrophil, Lymphocyte, Mortality, Neutrophil-to-lymphocyte ratio

摘要：

背景　目前心力衰竭患者的死亡率仍然很高，且国内外关于中性粒细胞与淋巴细胞比值与心力衰竭患者5年全因死亡的相关性临床研究较为缺乏。目的　分析心力衰竭患者中性粒细胞与淋巴细胞比值与5年全因死亡的关系。方法　本研究为单中心回顾性研究，选取2012年8月—2013年7月于广西医科大学第一附属医院住院的成年症状性心力衰竭〔纽约心脏病协会（NYHA）心功能分级Ⅲ~Ⅳ级〕患者418例为研究对象，收集患者的临床资料并电话随访了解心力衰竭患者的5年全因死亡情况。根据患者中性粒细胞与淋巴细胞比值等分为4组，分析中性粒细胞与淋巴细胞比值与心力衰竭患者5年全因死亡率的关系。结果　本研究心力衰竭患者全因死亡率为55.3%（231/418）。单因素分析结果显示，尿素、肌酐、胱抑素C、肌酸激酶同工酶、N末端B型利钠肽前体、心功能分级、中性粒细胞与淋巴细胞比值高是心力衰竭患者5年全因死亡的危险因素（P<0.05），而体质量高、三酰甘油水平高、使用β-受体阻滞剂是心力衰竭患者5年全因死亡的保护因素（P<0.05），女性心力衰竭患者5年全因死亡发生风险低于男性（P<0.05）。在校正了多种混杂因素后，中性粒细胞与淋巴细胞比值仍然是心力衰竭患者5年全因死亡的独立预测因素（P<0.05）。结论　中性粒细胞与淋巴细胞比值是心力衰竭患者5年全因死亡的独立预测因素，比值越高，风险越大。

关键词: 心力衰竭, 中性粒细胞, 淋巴细胞, 死亡率, 中性粒细胞与淋巴细胞比值

LUO Faxin,YE Ziliang,ZHU Jijin. Neutrophil-to-lymphocyte Ratio and 5-year All-cause Mortality in Patients with Heart Failure　[J]. Chinese General Practice, 2019, 22(34): 4213-4219. DOI: 10.12114/j.issn.1007-9572.2019.00.632.
罗发新,叶自亮,朱继金. 心力衰竭患者中性粒细胞与淋巴细胞比值与5年全因死亡的关系研究[J]. 中国全科医学, 2019, 22(34): 4213-4219. DOI: 10.12114/j.issn.1007-9572.2019.00.632.

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