摘要
目的探讨尿酸(UA)、红细胞分布宽度(RDW)、中性粒细胞与淋巴细胞的比值(NLR)对非瓣膜性心房颤动(NVAF)左心房血栓形成的影响。方法回顾性分析2014年12月~2020年5月收治的578例NVAF患者的临床资料,经食管超声心动图检查分为血栓形成组(72例)和对照组(506例)。记录两组一般资料,比较两组RDW、UA、NLR,Spearman性分析UA、NLR、RDW与各指标的相关;多因素logistic回归分析UA、NLR、RDW对左心房血栓形成的影响,ROC曲线评定RDW、UA、NLR预测左心房血栓形成的临床价值。结果单因素分析显示,血栓形成组RDW、UA、NLR、左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心房内径(LAD)、CHA2DS2-VASc评分与对照组比较差异均有统计学意义(P<0.05);Spearman相关性分析显示,UA、NLR、RDW与LVESD、LAD、CHA2DS2-VASc呈正相关(P<0.05),与LVEF呈负相关(P<0.05)。多因素logistic回归分析结果显示,UA、NLR、RDW是NVAF患者左心房血栓形成的危险因素(P<0.05);ROC曲线显示,UA、RDW、NLR预测NVAF患者左心房血栓形成的AUC分别为0.759、0.820、0.789,三者联合预测的AUC(0.872)高于单独预测。结论UA、NLR、RDW是NVAF患者左心房血栓形成的独立危险因素,三者联合检测对左心房血栓形成具有较高的预测价值。
Objective To explore the effect of uric acid(UA),red blood cell distribution width(RDW),neutrophil to lymphocyte ratio(NLR) on left atrial thrombosis in patients with non-valvular atrial fibrillation(NVAF).Methods The clinical data of 578 patients with NVAF from December 2014 to May 2020 were retrospectively analyzed.According to transesophageal echocardiography, they were divided into the thrombosis group(72 cases) and the control group(506 cases).The general information, the values of RDW,UA and NLR in two groups were recorded.Spearman analysis was performed to clarify the correlation between UA,NLR,RDW and various indicators.Multivariate logistic regression was used to analyze the effect of UA,NLR,RDW on left atrial thrombosis.Receiver operating characteristic(ROC) curve was used to assess the clinical value of RDW,UA and NLR in predicting left atrial thrombosis.Results Univariate analysis revealed that there were significant differences in RDW,UA,NLR,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left atrium inner diameter(LAD),and CHA2 DS2-VASc score between the thrombosis group and the control group(P<0.05).Spearman analysis showed that UA,NLR,RDW were positively correlated with LVESD,LAD,CHA2 DS2-VASc(P<0.05),and negatively correlated with LVEF(P<0.05).Multivariate logistic regression analysis showed that UA,NLR,RDW were risk factors for left atrial thrombosis in patients with NVAF(P<0.05).ROC curve revealed that the area under curve(AUC) of UA,RDW,and NLR in predicting left atrial thrombosis in patients with NVAF was 0.759,0.820,and 0.789,respectively;and the combination of UA,RDW,and NLR revealed an AUC of 0.872 which was higher than that of the individual prediction.Conclusion UA,NLR and RDW are independent risk factors for left atrial thrombosis in NVAF patients.The combination of UA,NLR and RDW detection has a high predictive value for left atrial thrombosis.
作者
薛根山
韩叶光
贝筝
Xue Genshan;Han Yeguang;Bei Zheng(Cadre Sanatorium of Hainan(Geriatrics Hospital of Hainan),Haikou 571100)
出处
《国际老年医学杂志》
2022年第2期188-193,共6页
International Journal of Geriatrics
基金
海南省自然科学基金(817373)。
