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目的研究中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)与代谢综合征(metabolic syndrome,MS)的关系。方法本研究为回顾性研究,2011年10月—2013年12月就诊且资料完整的MS患者122例为MS组,另从同期体检的个体中按照年龄相仿、性别相同的原则挑选健康个体122例作为对照组。根据血常规检测结果中的中性粒细胞计数和淋巴细胞计数结果计算出患者的NLR。对照组与MS组临床特征的比较采用Wilcoxin配对检验(差值呈偏态分布的资料)或配对t检验(差值呈正态分布的资料),分类资料的比较采用Fisher确切概率法。采用受试者工作特征(receiver operating characteristic,ROC)曲线法分析白细胞计数、淋巴细胞和中性粒细胞计数、NLR对MS的鉴别效率。ROC曲线下面积(area under curve,AUC)的比较采用Delong等提出的方法,P<0.05为差异有统计学意义。结果与对照组相比,MS组患者高血压的发病率、空腹血糖水平、甘油三酯水平、白细胞计数、中性粒细胞计数和NLR[75/47、(8.2±1.9)、(3.3±4.0)mmol/L、(7.66±1.73)×109/L、(5.39±1.34)×109/L、3.03±1.48]明显增高(均P<0.05),淋巴细胞计数和高密度脂蛋白胆固醇浓度[(2.09±0.97)×109/L、(0.87±0.36)mmol/L]则明显降低(均P<0.05)。符合四条诊断标准的MS患者,中性粒细胞计数和NLR明显高于符合三项诊断标准的患者(均P<0.05)。白细胞计数和淋巴细胞计数在两组患者之间的区别则无统计学意义(均P>0.05)。在上述四个参数中,以NLR的曲线下面积最大,与其他三个参数之间的差异均有统计学意义(均P<0.05)。结论 NLR可以反映MS病情,其与MS的关联强度可能高于白细胞计数、淋巴细胞计数和中性粒细胞计数。
Objective To study the relationship between neutrophil to lymphocyte ratio (NLR) and metabolic syndrome (MS). Methods This study was a retrospective study. From October 2011 to December 2013, 122 MS patients with complete data were selected as the MS group. 122 healthy individuals were selected from the same period of the same physical examination according to the same age and gender As a control group. The patient’s NLR was calculated based on the neutrophil count and lymphocyte count results in the blood test. The clinical characteristics of the control group and the MS group were compared using the Wilcoxon paired test (the difference was skewed distribution data) or paired t-test (the difference was normal distribution data), the classification data were compared using the Fisher exact test. The receiver operating characteristic (ROC) curve method was used to analyze the white blood cell count, lymphocyte and neutrophil count, and the identification efficiency of NLR on MS. The area under curve (AUC) was compared using the method proposed by Delong et al. P <0.05 was considered statistically significant. Results Compared with the control group, the incidence of hypertension, fasting blood glucose, triglyceride, leukocyte count, neutrophil count and NLR [75/47 (8.2 ± 1.9), (3.3 ± 4.0) ), mmol / L, (7.66 ± 1.73) × 109 / L, (5.39 ± 1.34) × 109 / L and 3.03 ± 1.48] (all P < 2.09 ± 0.97) × 109 / L, (0.87 ± 0.36) mmol / L] (all P <0.05). MS patients who met the four diagnostic criteria had significantly higher neutrophil count and NLR than those who met the three diagnostic criteria (all P <0.05). There was no significant difference between the two groups in white blood cell count and lymphocyte count (all P> 0.05). Among the above four parameters, the area under the curve of NLR was the largest, with the other three parameters were statistically significant (P <0.05). Conclusion NLR can reflect the severity of MS. The correlation between MS and NLR may be higher than that of white blood cell count, lymphocyte count and neutrophil count.