摘要
目的探讨外周血中性粒细胞与淋巴细胞计数比值(neutrophil-to-lymphocyte ratio,NLR)对择期腹主动脉瘤腔内修复手术后并发症的预测价值。方法回顾性分析2016年8月至2021年11月期间,北京医院血管外科收治的腹主动脉瘤且首次行腔内隔绝修复术患者的临床资料,包括患者的基本信息、合并疾病、腹主动脉瘤最大瘤径、术前血常规、术后并发症、长期生存率等指标。确定最佳的外周血NLR,分析高NLR组与低NLR组2组之间的术后并发症及长期生存率的差异。结果本研究共纳入120例初次行腹主动脉瘤腔内隔绝术患者,其中男105例,女15例;年龄52~94岁、(73.3±8.26)岁,腹主动脉瘤最大瘤径35~100 mm、(58.5±12.48)mm。利用约登指数筛选得到预测腹主动脉瘤术后并发症的NLR最佳截断值为2.45,NLR≥2.45者为高NLR组(n=66),NLR<2.45者为低NLR组(n=54),2组患者术后总体并发症发生率及各分项并发症发生率比较差异均无统计学意义(P>0.05)。logistic回归分析结果提示NLR是腹主动脉瘤腔内修复术后并发症发生的独立危险因素(P<0.05)。高NLR组和低NLR组患者的中位生存时间分别为31.47个月和35.28个月,2组间比较差异无统计学意义(P>0.05)。结论外周血NLR可作为择期腹主动脉瘤腔内修复术后并发症的一个参考预测指标,但仍需更多研究结果的证实。
Objective To explore the predictive value of neutrophil-to-lymphocyte ratio(NLR)in peripheral blood for postoperative complications of elective endovascular repair for abdominal aortic aneurysm(AAA).Methods From August 2016 to November 2021,the clinical data of patients with AAA who received endovascular isolation repair for the first time in the Department of Vascular Surgery of Beijing Hospital were retrospectively analyzed,including the basic information of the patients,comorbid diseases,and the largest diameter of AAA,preoperative blood labotry test,postoperative complications,long-term survival rate and other indicators.The optimal NLR in peripheral blood was determined,and the differences in postoperative complications and long-term survival rates between the high NLR group and the low NLR group were analysed.Results A total of 120 patients with AAA underwent endovascular isolation for the first time were included in this study,including 105 males and 15 females.The age ranged from 52 to 94years,with an average of(73.3±8.26)years.The largest diameter of abdominal aortic aneurysm was 35 to 100 mm,with an average of(58.5±12.48)mm.The best cut-off value of NLR for predicting postoperative complications of AAA was 2.45 by using Yoden index screening.Those with NLR≥2.45 were in the high NLR group(n=66),and those with NLR≥2.45 were in the low NLR group(n=54).There was no statistically significant difference between the two groups in the incidence of overall complications and the incidence of sub-complications(P>0.05).The results of logistic regression analysis suggested that NLR was an independent risk factor for complications after endovascular repair of AAA(P<0.05).The median survival time of patients in the high NLR group and the low NLR group was 31.47 months and35.28 months,respectively,and there was no statistically significant difference between the two groups(P>0.05).Conclusion NLR can be used as a reference predictor of complications after elective endovascular repair of AAA,but more research results are still needed to confirm.
作者
吴志远
赵文心
苗雨晴
李志超
张熙浩
李瑞豪
陈作观
刁永鹏
兰勇
李拥军
WU Zhiyuan;ZHAO Wenxin;MIAO Yuqing;LI Zhichao;ZHANG Xihao;LI Ruihao;CHEN Zuoguan;DIAO Yongpeng;LAN Yong;LI Yongjun(Department of Vascular Surgery,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,P.R.China;Chinese Academy of Medical Sciences,Peking Union Medical College Graduate School,Beijing 100730,P.R.China;Peking University Health Science Center,Beijing 100191,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2023年第6期703-708,共6页
Chinese Journal of Bases and Clinics In General Surgery
