老年钙化性主动脉瓣狭窄与外周血炎性细胞及血脂水平的关系

摘要： 目的 探讨老年 （≥65岁） 患者发生钙化性主动脉瓣狭窄与其外周血炎性细胞水平及脂质代谢异常的相关性。方法 连续纳入2015年6月—2017年6月间在我院诊断为钙化性主动脉瓣狭窄的老年患者76例作为病例组，选取78例因胸部不适住院的老年人 （除外心脏瓣膜病） 作为对照组。2组入院时均检测白细胞计数 （WBC）、 中性粒细胞比例 （N%）、 中性粒细胞计数 （N）、 淋巴细胞计数 （L）、 中性粒细胞淋巴细胞比值 （NLR）、 超敏C-反应蛋白 （hs- CRP）、 氨基末端B型利钠肽原 （NT-pro BNP）、 总胆固醇 （TC）、 三酰甘油 （TG）、 载脂蛋白α （apo-α）、 高密度脂蛋白（HDL）、 低密度脂蛋白 （LDL）、 极低密度脂蛋白 （VLDL） 等指标， 比较这些指标在2组间的差异。结果 病例组WBC、 N%、 N、 NLR、 hs-CRP、 NT-pro BNP、 VLDL均高于对照组， L、 HDL均低于对照组 （P＜0.05）； 多因素回归分析显示， 吸烟、 hs-CRP及NT-pro BNP升高是老年钙化性主动脉瓣狭窄的独立危险因素。结论 老年钙化性主动脉瓣狭窄不是一种简单的退行性病变， 其与全身炎症反应、 脂质代谢异常有关。

Relationship between calcified aortic stenosis and peripheral blood inflammatory cells and lipids in the elderly

Abstract: Objective To investigate the relationship between calcific aortic valve stenosis and inflammatory cells in peripheral blood and dyslipidemia in elderly patients (age ≥65 years). Methods A total of 76 elderly patients (≥65 years old) diagnosed as calcific aortic stenosis in our hospital from June 2015 to June 2017 were selected as the case group, and 78 seniors (excluding valvular heart disease) hospitalized due to chest discomfort were selected as the control group. The white blood cell count (WBC), neutrophil ratio (N%), neutrophil count (N), lymphocyte count (L), neutrophil lymphocyte ratio (NLR), hypersensitive C-reactive protein (hs-CRP), N-terminal B-type natriuretic peptide (NT-pro BNP), total cholesterol (TC), triglyceride (TG), apo-α, high-density lipoprotein (HDL), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL) and other indicators were tested on admission. All these indicators were compared between the two groups. Results The levels of WBC, N%， N， NLR, hs-CRP, NT-pro BNP， VLDL were higher in the case group than those in the control group. The levels of L and HDL were significantly lower in the case group than those of the control group (P<0.05). Multiple regression analysis showed that smoking, the increased hs-CRP and NT-pro BNP levels were independent risk factors for senile calcific aortic stenosis. Conclusion Senile calcific aortic stenosis is not a simple degenerative disease. It is closely related to systemic inflammatory response and abnormal lipid metabolism.