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| 单核细胞计数与高密度脂蛋白胆固醇比值对患者双腔起搏器植入术后新发心房高频事件的预测价值 |
| 宋雪城1,吉立双1,马芳芳1,李敏1,王乐1,魏梅1,周欣2,郑明奇1,刘刚1* |
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(1. 河北医科大学第一医院心内科, 石家庄 050031;
2. 天津医科大学总医院心内科, 天津 300052
*通信作者) |
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| 摘要: |
| 目的 探讨单核细胞计数与高密度脂蛋白胆固醇比值（MHR）对缓慢性心律失常患者双腔起搏器植入术后新发心房高频事件（AHRE）的预测价值。方法 回顾性分析2013年6月至2018年6月于河北医科大学第一医院植入心脏双腔起搏器的患者资料，根据纳入及排除标准，最终140例患者入组。术后随访12个月，根据随访期间是否发生AHRE将患者分为发生AHRE组和未发生AHRE组，比较两组术前的基本资料和实验室指标。依据MHR三分位数将患者分为MHR<3.26组、MHR 3.26～5.00组及MHR>5.00组。通过Cox比例风险回归分析患者术后发生AHRE的风险。结果 患者年龄中位数为70.00（61.00，75.00）岁，共有28例患者随访期间监测到AHRE。随访期间发生AHRE患者与未发生AHRE患者相比，两组在白细胞计数、中性粒细胞计数、单核细胞计数、高密度脂蛋白胆固醇、MHR等方面的差异均有统计学意义（P均<0.05）。多因素Cox比例风险回归分析结果显示，MHR （HR=1.537，95% CI 1.209～1.955，P<0.001）增加了双腔起搏器植入术后患者新发AHRE的风险。与MHR<3.26组相比，MHR 3.26～5.00组（HR=1.811，95% CI 0.366～8.958，P=0.467）患者发生AHRE的风险无明显变化，MHR>5.00组（HR=10.128，95% CI 2.051～50.003，P=0.004）患者发生AHRE的风险增高。结论 血液MHR是反映炎症和氧化应激水平的新标志物，其高水平增加了缓慢性心律失常患者双腔起搏器植入术后新发AHRE的风险。 |
| 关键词: 心房高频事件 单核细胞 高密度脂蛋白胆固醇 人工心脏起搏器 炎症 氧化性应激 |
| DOI：10.16781/j.0258-879x.2021.01.0041 |
| 投稿时间：2020-03-11修订日期：2020-11-25 |
| 基金项目:河北省科学技术厅惠民工程（16277707D），河北省卫生和计划生育委员会一般项目（20170060）. |
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| Predictive vaule of monocyte count to high-density lipoprotein-cholesterol ratio for new atrial high-rate episodes after dual-chamber pacemaker implantation |
| SONG Xue-cheng1,JI Li-shuang1,MA Fang-fang1,LI Min1,WANG Le1,WEI Mei1,ZHOU Xin2,ZHENG Ming-qi1,LIU Gang1* |
(1. Department of Cardiology, the First Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei, China;
2. Department of Cardiology, Tianjin Medical University General Hospital, Tianjin 300052, China
*Corresponding author) |
| Abstract: |
| Objective To explore the predictive value of monocyte count to high-density lipoprotein-cholesterol ratio (MHR) for new atrial high-rate episodes (AHREs) in patients with bradycardiac arrhythmia after dual-chamber pacemaker implantation. Methods The data of patients implanted with dual-chamber pacemaker in the First Hospital of Hebei Medical University from Jun. 2013 to Jun. 2018 were retrospectively analyzed. According to the inclusion and exclusion criteria, 140 patients were finally included. The patients were followed up for 12 months, and then divided into AHREs group and non-AHREs group according to whether AHREs occurred during the follow-up period. The general characteristics and the laboratory indexes were compared between the two groups. Furthermore, all patients were divided into MHR<3.26 group, MHR 3.26-5.00 group and MHR>5.00 group. Cox proportional hazards regression analysis was used to analyze the risk of AHREs. Results The median age of the patients was 70.00 (61.00, 75.00) years. AHREs were detected in 28 patients during the follow-up. There were significant differences in white blood cell count, neutrophil count, monocyte count, high-density lipoprotein-cholesterol and MHR in the patients with AHREs compared with the non-AHREs group during the follow-up (all P<0.05). Multivariate Cox proportional hazards regression analysis showed that MHR (HR=1.537, 95% CI 1.209-1.955, P<0.001) increased the risks of new AHREs after dual-chamber pacemaker implantation. Compared with the MHR<3.26 group, the risk of AHREs in the MHR 3.26-5.00 group (HR=1.811, 95% CI 0.366-8.958, P=0.467) had no significant change, while the risk of AHREs in the MHR>5.00 group (HR=10.128, 95% CI 2.051-50.003, P=0.004) was increased significantly. Conclusion As a new marker of inflammation and oxidative stress in blood, high MHR increases the risk of new AHREs in patients with bradycardiac arrhythmia after dual-chamber pacemaker implantation. |
| Key words: atrial high-rate episodes monocytes high-density lipoprotein-cholesterol artificial pacemaker inflammation oxidative stress |
