Neutrophil/lymphocyte ratio as a predictor of cardiovascular events in incident dialysis patients: a Japanese prospective cohort study
Neutrophil/lymphocyte ratio as a predictor of cardiovascular events in incident dialysis patients: a Japanese prospective cohort study
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DOI：
10.1007/s10157-014-1046-2
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发表时间：
2015-08-01
影响因子：
2.3
通讯作者：
Maruyama, Shoichi
中科院分区：
文献类型：
--
作者：
Abe, Tomoko;Kato, Sawako;Maruyama, Shoichi
以往的研究表明，高中性粒细胞/淋巴细胞比值与心血管疾病患者的预后不良有关。终末期肾病患者，特别是炎症患者，过早死亡的风险增加，主要是因为心血管疾病。我们的目的是澄清是否高中性粒细胞/淋巴细胞比例与日本终末期肾病患者心血管事件增加有关。我们在一项前瞻性队列研究中纳入了86例日本透析患者（58例男性，年龄58 ± 11岁）。中位随访时间为38.7个月。研究了透析治疗开始时中性粒细胞/淋巴细胞比值与临床生物标志物之间的相关性。计算相对危险度和累积心血管疾病事件，中性粒细胞/淋巴细胞比值中位数为3.72。随着中性粒细胞/淋巴细胞比率的增加，从透析治疗开始至首次心血管疾病事件的持续时间显著缩短（对数秩检验，P = 0.003）。在考克斯比例风险模型中，中性粒细胞/淋巴细胞比值>中位数的患者发生心血管疾病事件与比值<中位数的患者发生心血管事件的相对风险为3.02（95% CI 1.32-8.00）。中性粒细胞/淋巴细胞比值>中位数的患者（23.0起事件100人-年）在观察期间的累积心血管疾病事件高于比值<中位数的患者（6.8起事件100人-年）。较高的中性粒细胞/淋巴细胞比值与心血管疾病事件风险增加相关，是未来事件的更强预测因子。
Previous studies have suggested that high neutrophil/lymphocyte ratios are related to worse outcome in patients with cardiovascular diseases. Patients with end-stage renal disease, especially those with inflammation, are at an increased risk of premature mortality, primarily because of cardiovascular disease. We aimed to clarify if high neutrophil/lymphocyte ratio is associated with increasing cardiovascular events in Japanese patients with end-stage renal disease.We enrolled 86 incident Japanese dialysis patients (58 men, age 58 +/- A 11 years) in a prospective cohort study. The median follow-up was for 38.7 months. The association between neutrophil/lymphocyte ratio at the start of dialysis therapy and clinical biomarkers was investigated. Relative risks and cumulative cardiovascular disease events were calculated.The median neutrophil/lymphocyte ratio reported was 3.72. The duration from the start of the dialysis therapy to the first cardiovascular disease event was significantly shorter as a neutrophil/lymphocyte ratio increased (log-rank test, P = 0.003). The relative risk of cardiovascular disease events in patients with neutrophil/lymphocyte ratio > median to cardiovascular events in patients with the ratio < median as a reference was 3.02 (95 % CI 1.32-8.00) in a Cox proportional hazard model. The cumulative cardiovascular disease events during the observational period was higher in patients with neutrophil/lymphocyte ratio > median (23.0 events 100 person-years) than in patients with the ratio < median (6.8 events 100 person-years).A higher neutrophil/lymphocyte ratio is associated with increased risk of cardiovascular disease events and is a stronger predictor of future events.