中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2015年
3期
264-268
,共5页
张上仕%朱红艳%赵若池%郑小军%陆琦%刘善湖%崔翰斌
張上仕%硃紅豔%趙若池%鄭小軍%陸琦%劉善湖%崔翰斌
장상사%주홍염%조약지%정소군%륙기%류선호%최한빈
白细胞%心肌梗死%血管成形术,经腔,经皮冠状动脉%预后
白細胞%心肌梗死%血管成形術,經腔,經皮冠狀動脈%預後
백세포%심기경사%혈관성형술,경강,경피관상동맥%예후
Leukocytes%Myocardial infarction%Angioplasty,transluminal,percutaneous coronary%Prognosis
目的 荟萃分析中性粒细胞与淋巴细胞比值(NLR)对经皮冠状动脉介入治疗(PCI)后ST段抬高型心肌梗死(STEMI)患者近、远期预后的预测价值.方法 检索PubMed、EMBASE和万方数据库中自建库至2014年6月发表的NLR与STEMI患者预后相关的文献,并追踪获取文献的参考文献.按照文献纳入标准,用标准表格提取纳入文献的相关资料.应用RevMan 5.2软件进行荟萃分析.结果 荟萃分析共纳入6篇临床试验文献,1 953例患者.与NLR＞ 3.30患者相比,NLR≤3.30患者PCI术后住院期间和远期(≥12个月)全因死亡(住院期间RR:0.29,95％ CI:0.19 ～ 0.46,P＜0.001;远期RR:0.33,95％ CI:0.23 ～0.45,P＜0.001)、主要不良心血管事件(住院期间RR:0.38,95％ CI:0.31 ～0.46,P＜0.001;远期RR:0.27,95％ CI:0.20 ～0.35,P＜0.001)的风险均较低;此外,NLR≤3.30患者在住院期间发生非致命性心肌梗死(RR:0.43,95％ CI:0.28 ～0.67,P＜0.001)、支架内血栓形成(RR:0.32,95％ CI:0.19 ～0.53,P＜0.001)和术后冠状动脉血流＜TIMI 3级(RR:0.34,95％ CI:0.14 ～0.86,P=0.020)的风险亦较低.结论 荟萃分析表明,NLR对PCI术后STEMI患者近、远期预后有预测价值,但需要大规模随机临床试验的进一步证实.
目的 薈萃分析中性粒細胞與淋巴細胞比值(NLR)對經皮冠狀動脈介入治療(PCI)後ST段抬高型心肌梗死(STEMI)患者近、遠期預後的預測價值.方法 檢索PubMed、EMBASE和萬方數據庫中自建庫至2014年6月髮錶的NLR與STEMI患者預後相關的文獻,併追蹤穫取文獻的參攷文獻.按照文獻納入標準,用標準錶格提取納入文獻的相關資料.應用RevMan 5.2軟件進行薈萃分析.結果 薈萃分析共納入6篇臨床試驗文獻,1 953例患者.與NLR＞ 3.30患者相比,NLR≤3.30患者PCI術後住院期間和遠期(≥12箇月)全因死亡(住院期間RR:0.29,95％ CI:0.19 ～ 0.46,P＜0.001;遠期RR:0.33,95％ CI:0.23 ～0.45,P＜0.001)、主要不良心血管事件(住院期間RR:0.38,95％ CI:0.31 ～0.46,P＜0.001;遠期RR:0.27,95％ CI:0.20 ～0.35,P＜0.001)的風險均較低;此外,NLR≤3.30患者在住院期間髮生非緻命性心肌梗死(RR:0.43,95％ CI:0.28 ～0.67,P＜0.001)、支架內血栓形成(RR:0.32,95％ CI:0.19 ～0.53,P＜0.001)和術後冠狀動脈血流＜TIMI 3級(RR:0.34,95％ CI:0.14 ～0.86,P=0.020)的風險亦較低.結論 薈萃分析錶明,NLR對PCI術後STEMI患者近、遠期預後有預測價值,但需要大規模隨機臨床試驗的進一步證實.
목적 회췌분석중성립세포여림파세포비치(NLR)대경피관상동맥개입치료(PCI)후ST단태고형심기경사(STEMI)환자근、원기예후적예측개치.방법 검색PubMed、EMBASE화만방수거고중자건고지2014년6월발표적NLR여STEMI환자예후상관적문헌,병추종획취문헌적삼고문헌.안조문헌납입표준,용표준표격제취납입문헌적상관자료.응용RevMan 5.2연건진행회췌분석.결과 회췌분석공납입6편림상시험문헌,1 953례환자.여NLR＞ 3.30환자상비,NLR≤3.30환자PCI술후주원기간화원기(≥12개월)전인사망(주원기간RR:0.29,95％ CI:0.19 ～ 0.46,P＜0.001;원기RR:0.33,95％ CI:0.23 ～0.45,P＜0.001)、주요불양심혈관사건(주원기간RR:0.38,95％ CI:0.31 ～0.46,P＜0.001;원기RR:0.27,95％ CI:0.20 ～0.35,P＜0.001)적풍험균교저;차외,NLR≤3.30환자재주원기간발생비치명성심기경사(RR:0.43,95％ CI:0.28 ～0.67,P＜0.001)、지가내혈전형성(RR:0.32,95％ CI:0.19 ～0.53,P＜0.001)화술후관상동맥혈류＜TIMI 3급(RR:0.34,95％ CI:0.14 ～0.86,P=0.020)적풍험역교저.결론 회췌분석표명,NLR대PCI술후STEMI환자근、원기예후유예측개치,단수요대규모수궤림상시험적진일보증실.
Objective To analyze the value of neutrophils/lymphocytes ratio (NLR) on predicting the cardiovascular events at hospital discharge and ≥ 12 months follow-up for patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) by meta-analysis.Methods Both English and Chinese databases,including PubMed,EMBASE,Wanfang database from their reception to June 2014 were searched to identify randomized controlled studies or non-randomized controlled studies that reported relationship between NLR and the prognosis of patients with STEMI undergoing PCI.The Newcastle-OttawaScale (NOS) system was employed to assess the quality of literatures enrolled in this study.Two reviewers assessed the quality of each trial and extracted data independently.A standardized form and RevMan 5.2 software were used to extract information,and perform quantitative analysis,respectively.Results A total of 1 953 patients from 6 clinical trials were included in this meta-analysis.The risks of all-cause mortality (RR:0.29,95％ CI:0.19-0.46,P ＜ 0.001),major adverse cardiac events (RR:0.38,95％ CI:0.31-0.46,P ＜ 0.001),nonfatal myocardial infarction (RR:0.43,95 ％ CI:0.28-0.67,P ＜ 0.001),stent thrombosis (RR:0.32,95 ％ CI:0.19-0.53,P ＜ 0.001),and TIMI flow after PCI procedure ＜ 3 grade (RR:0.34,95％ CI:0.14-0.86,P =0.020) were significantly lower in patients with NLR ≤3.30 compared patients with NLR ＞ 3.30 at hospital discharge.During ≥ 12 months follow-up,the risks of death (RR:0.33,95％ CI:0.23-0.45,P ＜ 0.001),major adverse cardiac events (RR:0.27,95 ％ CI:0.20-0.35,P ＜ 0.001) were significantly lower.Whereas nonfatal myocardial infarction was not significantly different (RR:0.42,95％ CI:0.05-3.45,P =0.420) in patients with NLR≤3.30 compared patients with NLR ＞ 3.30.Conclusions Results from this meta-analysis show that the NLR could predict short-and long-term prognosis in patients with STEMI undergoing PCI.This finding needs to be validated by large-scale clinical trials in the future.
