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基于血细胞的炎症指数及其变化和在接受过导管大动脉置换的患者的死亡率之间的关联:与前性多中心队列验证研究进行回顾性调查

Weiya Li^1,2,3, Hongde Li^1,2,3, Shiqin Peng^1,2,3

¹Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.

International journal of surgery (London, England)

|December 17, 2025

概括

透气管术后的大动脉置换 (TAVR) 炎症标志物,包括中性粒细胞与淋巴细胞比率 (NLR),血小板与淋巴细胞比率 (PLR) 和中性粒细胞百分比与白蛋白比率 (NPAR),比TAVR前的值更好地预测死亡率. NPAR是风险分层的最强有力的预测指标.

科学领域:

心血管医学心血管医学
炎症和免疫学炎症和免疫学
医学诊断医学诊断医学诊断

背景情况:

慢性炎症驱动心血管疾病,如膜化.
中性粒细胞与淋巴细胞的比率 (NLR),血小板与淋巴细胞的比率 (PLR) 和中性粒细胞百分比与白蛋白的比率 (NPAR) 是系统性炎症的关键标志物.
关于这些标记物的动态变化存在有限的研究,这些标记物预测了透气管后大动脉置换 (TAVR) 后的结果.

研究的目的:

评估TAVR前后炎症标志物 (NLR,PLR,NPAR) 对所有原因死亡率的预测值.
评估这些标志物的动态变化对死亡风险的影响.
为了比较TAVR前与TAVR后炎症标志物水平的预测能力.

主要方法:

回顾性单中心队列 (n=1629) 和前性多中心队列 (n=443) 研究.
在TAVR前后的NLR,PLR和NPAR的基础上分层成三角形.
使用多变量考克斯回归,受限立方线 (RCS) 和时间依赖的ROC曲线分析.

主要成果:

在TAVR前和后的NLR,PLR和NPAR的高三位数与所有原因死亡率的增加有关.
后TAVR炎症标志物显示出比前TAVR值更大的死亡预测值.
与基线相比,TAVR后标志物的增加显著增加了死亡风险;研究结果在预期队列中得到了验证.

结论:

与TAVR前值相比,TAVR后的NLR,PLR和NPAR是死亡率的优越预测指标,NPAR是最重要的.
这些基于血细胞的炎症标志物使TAVR患者的风险精确分层成为可能.
建议对这些标志物,特别是NPAR进行进一步的干预研究.

关键词:

死亡率死亡率中性粒细胞百分比与白蛋白的比率.中性粒细胞与淋巴细胞的比率.血小板与淋巴细胞的比率.通过导管更换大动脉门.

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