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目的:探讨炎症因子水平对全因死亡的预测价值。方法:采用前瞻性队列研究,以参加2006-07至2007-10开滦集团公司健康体检的在职及离、退休职工为研究对象,排除急性炎症及资料不全者,最终83 228名受试者纳入研究队列,每年收集1次员工死亡信息,末次随访时间为2013-12-31。将研究对象分别按基线白细胞计数(WBC)、中性粒细胞与淋巴细胞比率(NLR)、C反应蛋白(CRP)的四分位数分组,比较各组全因死亡率,并采用多因素Cox回归模型分析各组全因死亡的发生风险。结果:平均随访6.9年后,基线WBC第一、二、三、四四分位组的全因死亡率分别为4.2%、4.5%、4.5%和5.0%(P<0.001);基线NLR第一、二、三、四四分位组的全因死亡率分别为3.3%、3.6%、4.5%和6.7%(P<0.001);基线CRP第一、二、三、四四分位组的全因死亡率分别为3.0%、3.6%、4.8%和6.8%(P<0.001)。多因素Cox回归分析结果显示,校正年龄、性别、腰围等混杂因素后,随着基线WBC、NLR和CRP水平升高,全因死亡的发生风险均呈递增趋势,且基线WBC、NLR、CRP第四四分位组发生全因死亡的风险分别为第一四分位组的1.17[95%可信区间(CI):1.06~1.29]、1.44(95%CI:1.31~1.59)、1.33(95%CI:1.20~1.47)倍。结论:WBC、NLR和CRP水平均为全因死亡的独立预测因子。
Objective: To investigate the predictive value of inflammatory cytokines in all-cause mortality. METHODS: A prospective cohort study was conducted with 83,028 subjects enrolled, both on-the-job and retired workers who participated in the physical examination of the Kailuan Group Company from July 2006 to October 2007 as research subjects, excluding acute inflammation and incomplete data Study cohort, collects employee death information once a year, the last follow-up time is 2013-12-31. The subjects were grouped according to the quartile of baseline WBC, NLR and CRP, and all-cause mortality was compared between groups. Multivariate Cox Regression model was used to analyze the risk of all-cause death in each group. RESULTS: After a mean follow-up of 6.9 years, the all-cause mortality rates for Baseline WBCs 1, 2, 3 and 4 were at 4.2%, 4.5%, 4.5% and 5.0%, respectively (P <0.001) , And all-cause mortality rates in the second, third, fourth and fourth quartiles were 3.3%, 3.6%, 4.5% and 6.7%, respectively (P <0.001). The overall CRF in the first, second, third and fourth quartiles Mortality rates were 3.0%, 3.6%, 4.8% and 6.8%, respectively (P <0.001). Multivariate Cox regression analysis showed that the risk of all-cause mortality increased with the increase of baseline WBC, NLR and CRP after adjusting for age, sex, waist circumference and other confounding factors, and the baseline WBC, NLR, CRP The risk for all-cause mortality in the four-quartile group was 1.17 [95% confidence interval (CI): 1.06-1.29], 1.44 (95% CI: 1.31-1.59), 1.33 % CI: 1.20 ~ 1.47) times. Conclusion: WBC, NLR and CRP levels are all independent predictors of all-cause mortality.