目的:旨在探讨中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio, NLR)对心房颤动患者射频消融术后复发的预测价值。方法:回顾性选取2018年1月至2022年12月期间在江苏省扬州大学附属医院接受射频导管消融术的心房颤动患者为研...
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目的:旨在探讨中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio, NLR)对心房颤动患者射频消融术后复发的预测价值。方法:回顾性选取2018年1月至2022年12月期间在江苏省扬州大学附属医院接受射频导管消融术的心房颤动患者为研究对象。所有患者均在术后随访1年,根据术后是否发生持续时间 ≥ 30 s的房颤、房扑、房速将患者分为复发组和未复发组。结果:本研究共纳入接受射频导管消融术的心房颤动患者164例,其中男性101例,女性63例,复发组29例,未复发组135例。两组间比较,复发组术前中性粒细胞计数、淋巴细胞计数、NLR、左房内径(left atrial diameter, LAD)高于未复发组,复发组术前高密度脂蛋白胆固醇(HDL-c)低于未复发组,差异有统计学意义(P 0.05)。二元logistic回归分析显示,消融前HDL-c (OR = 0.046, 95%CI = 0.003~0.718, P = 0.028)、NLR (OR = 4.830, 95%CI = 2.118~11.010, P Objective: The purpose of this study was to explore the value of neutrophil to lymphocyte ratio in predicting recurrence after radiofrequency ablation in patients with atrial fibrillation. Methods: Patients with atrial fibrillation who underwent radiofrequency catheter ablation in the Affiliated Hospital of Yangzhou University in Jiangsu Province from January 2018 to December 2022 were retrospectively selected. All patients were followed up for 1 year. According to the occurrence of atrial fibrillation, atrial flutter and atrial tachycardia with duration ≥ 30 s after the operation, the patients were divided into a recurrent group and a non-recurrent group. Result: A total of 164 patients with atrial fibrillation who underwent radiofrequency catheter ablation were included in this study, including 101 males and 63 females, 29 patients with recurrence and 135 patients without recurrence. The preoperative neutrophil count, lymphoid cell count, neutrophil to lymphocyte ratio and left atrial diameter in the recurrent group were higher than those in the non-recurrent group, while the preoperative high density lipoprotein cholesterol in the recurrent group was significantly lower than that in the non-recurrent group (P 0.05). Binary logistic regression analysis showed that HDL-c (OR = 0.046, 95%CI = 0.003~0.718, P = 0.028), NLR (OR = 4.830, 95%CI = 2.118~11.010, P < 0.001) and LAD (OR = 1.225, 95%CI = 1.082~1.386, P = 0.001) were independent risk factors for predicting recurrence of atrial fibrillation a
背景钠-葡萄糖共转运蛋白2抑制剂(SGLT2i)作为降糖药,在心-肾-内分泌协同管理的背景下被证实能有效改善心力衰竭、慢性肾脏疾病和糖尿病患者预后,但其对于急性心肌梗死(AMI)患者临床获益仍备受争议。目的探讨SGLT2i对AMI患者经皮冠状动脉介入治疗(PCI)术后主要不良心血管事件(MACEs)发生率的影响。方法通过检索PubMed、Web of Science、Embase数据库筛选关于SGLT2i应用于AMI患者PCI术后的相关研究,由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用STATA 16.0软件进行Meta分析。结果本研究共纳入8项研究,共计16643例AMI患者。相较于PCI术后常规的二级预防,SGLT2i的加用不能降低患者全因死亡率(OR=0.88,95%CI=0.61~1.29,P=0.052)、心源性死亡率(OR=1.04,95%CI=0.83~1.30,P=0.735)、全因再入院率(OR=1.00,95%CI=0.91~1.14,P=0.952)和患者二次血运重建的发生(OR=0.87,95%CI=0.58~1.30,P=0.486),但可以有效降低AMI患者因心力衰竭再入院率(OR=0.71,95%CI=0.60~0.83,P<0.01),并且不增加重度药物不良反应事件的发生率(OR=0.99,95%CI=0.91~1.09,P=0.903)。结论加用SGLT2i可安全、有效地降低AMI患者PCI术后心力衰竭再入院率,对于其他MACEs的影响仍需更多高质量的随机对照研究加以佐证。
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