急性心肌梗死患者冠脉搭桥术前中性粒细胞-淋巴细胞比率与围术期心肌损伤相关分析

目的：探讨急性心肌梗死患者冠脉搭桥（CABG）术前中性粒细胞．淋巴细胞比率（NLR）与围术期心肌损伤的关系，为，临床CABG围术期心肌保护提供参考依据。方法：选取2012年1月至2012年6月于首都医科大学附属北京安贞医院因急性心肌梗死接受冠脉搭桥手术（CABG）患者210例，收集术前血常规及术后肌钙蛋白I（cTnI）？Life酸激酶同工酶（CK-MB），计算NLR；采用四分位法根据NLR水平将患者分为四组，比较各组cTnI及CK—MB峰值，多元逐步回归分析NLR与cTnI及CK-MB峰值的相关性。结果：随着NLR水平升高，高血压病史和射血分数〈50％患者比例逐渐增多；白细胞计数、术后CK-MB及cTnI峰值、术后血肌酐值均逐渐增加；多元逐步回归分析显示，NLR、WBC分别与cTnI峰值呈正相关（r=0．526，r=0．186，P〈0．05）。结论：术前NLR、WBC与cTnI峰值呈正相关，NLR可能是反应急性心肌梗死患者冠脉搭桥围术期心肌损伤的良好标志物。

Correlation of Preoperative Neutrophil to Lymphocyte Ratio with Perioperative Myocardial Injury after Coronary Artery Bypass Surgery in Patients with AMI

Objective： To study the correlation of preoperative neutrophil to lymphocyte ratio（NLR） withperioperative myocardial injury after coronary artery bypass surgery （CABG） in patients with AMIat admission. Methods： Two hundred and ten CABG patients with AMI, admitted to Beijing Anzhen Hospital from January 2012 to June 2012.Preoperative white blood cells count （WBC）, neutrophil count （NC）, lymphocyte count （LC）, postoperative troponin I （cTnI） and creatine kinase isoenzyme （CK - MB ） were measured at admission and NLR were calculated. Patients were divided into four groups according to NLR. Difference in their peak cTnI and CK-MB values were compared and correlation of NLR with peak cTnI and CK-MB values was analyzed. Results： With the increment of NLR, the proportions with hypertension history or ejection fraction 〈50%, WBC, peak cTnI and CK-MB values were significantly higherA1]. Multiple stepwise regression analysis showed that the WBC and NLR were positively correlated with the peak cTnI value （r=0.526, r=0. 186, P 〈0.05 ）. Conclusions：The WBC count and NLR are positively correlated with the peak cTnI values after coronary artery bypass surgery in patients with AMI at admission in a significant linear manner, indicating that NLR is a good indication for perioperative myocardial injury after coronary artery bypass surgery in patients with AMI.