中性粒细胞与淋巴细胞比值与老年心血管疾病患者全因死亡的相关性研究<sup>*</sup>

doi:10.3969/j.issn.1671-7171.2026.05.002

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摘要 【目的】探讨老年心血管疾病(CVD)患者中性粒细胞与淋巴细胞比值(NLR)与全因死亡的关系。【方法】纳入1999-2018年美国国家健康与营养检查调查中的老年CVD患者3206例,根据NLR的四分位数分成4组,即Q1组(NLR＜1.74)、Q2组(1.74≤NLR＜2.37)、Q3组(2.37≤NLR＜3.23)和Q4组(NLR≥3.23)。分析NLR与全因死亡的关系,评估NLR对全因死亡的预测价值。【结果】Kaplan-Meier生存分析显示,高NLR组存在较低的生存率;Cox比例风险回归模型显示,在调整混杂因素后,NLR水平升高与全因死亡风险呈现显著的递增趋势(P<0.05);与Q1组相比,Q4组的全因死亡风险增加45%(P<0.05),NLR与全因死亡风险呈非线性正相关(P<0.05)。时间依赖性受试者工作特征(ROC)曲线分析显示,NLR预测老年CVD患者1年、3年、5年和10年全因死亡的曲线下面积分别为0.649、0.625、0.617和0.597。【结论】NLR 水平升高与老年CVD患者的全因死亡独立相关, 有助于识别高危的老年CVD患者。

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关键词 ：中性粒细胞, 淋巴细胞, 心血管疾病, 老年人, 数据相关性

Abstract：【Objective】 To investigate the relationship between neutrophil to lymphocyte ratio (NLR) and all-cause mortality in elderly patients with cardiovascular disease (CVD). 【Methods】 A total of 3206 elderly patients with CVD were included from the National Health and Nutrition Examination Survey of America from 1999 to 2018. The participants were divided into four groups according to the quartiles of NLR: Q1 (NLR<1.74), Q2 (1.74≤NLR< 2.37), Q3 (2.37≤NLR < 3.23), and Q4 (NLR≥3.23). The association between NLR and all-cause mortality was analyzed, and the predictive value of NLR for all-cause mortality was evaluated. 【Results】 The Kaplan-Meier survival analysis showed that the higher NLR level group had a lower survival rate. The Cox proportional hazards regression model showed that after adjusting for confounding factors, there is a significant positive association between elevated NLR levels and the risk of all-cause mortality. Compared with the lowest NLR level group Q1, the highest NLR level group Q4 had a 45% increased risk of all-cause mortality (P<0.05). Restricted cubic spline analysis showed a non-linear positive correlation between NLR and all-cause mortality risk (P<0.05). The time-dependent receiver operating characteristic (ROC) curve analysis showed that the area under the curve for predicting all-cause mortality in elderly CVD patients using NLR at 1, 3, 5, and 10 years were 0.649, 0.625, 0.617, and 0.597, respectively. 【Conclusion】 Elevated NLR levels are independently associated with increasing all-cause mortality in elderly patients with cardiovascular disease, which helps identify high-risk individuals in this population.

Key words： Neutrophils Lymphocytes Cardiovascular Diseases Aged Correlation of Data

收稿日期: 2025-11-28

中图分类号:

R543

基金资助:*河南省医学科技攻关计划联合共建项目(编号:LHGJ20210098)

通讯作者: **E-mail: yanghonghui@zzu.edu.cn

引用本文:

杨亚攀, 徐桂安, 朱利杰, 杨延杰, 王澈, 李清曼, 杨宏辉. 中性粒细胞与淋巴细胞比值与老年心血管疾病患者全因死亡的相关性研究^*[J]. 医学临床研究, 2026, 43(5): 708-712.
YANG Yapan, XU Gui'an, ZHU Lijie, YANG Yanjie, WANG Che, LI Qingman, YANG Honghui. Association between Neutrophil to Lymphocyte Ratio and All-Cause Mortality in Elderly Patients with Cardiovascular Disease. JOURNAL OF CLINICAL RESEARCH, 2026, 43(5): 708-712.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.05.002 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I5/708

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