Page 85 - 南京医科大学学报自然科学版

第43卷第1期 南京医科大学学报（自然科学版）
2023年1月 Journal of Nanjing Medical University（Natural Sciences） · 79 ·

·临床研究·

NLR、RDW联合多层螺旋CT对肺高压严重程度的评估

史阳阳，钱 骏，史薪炜，孙 凯 *
南京医科大学第一附属医院急诊科，江苏 南京 210029

［摘 要］ 目的：采用中性粒细胞/淋巴细胞比值（neutrophil/lymphocyte ratio，NLR）、红细胞分布宽度（red cell distribution
width，RDW）联合多层螺旋 CT（multislice spiral CT，MSCT）分析肺高压（pulmonary hypertention，PH）患者的临床特征，探讨与
疾病严重程度的相关性。方法：收集南京医科大学第一附属医院 2018 年 8 月—2022 年 2 月由经胸超声心动图（transthoracic
echocardiography，TTE）评估为 PH 的 124 例患者作为 PH 组，同期收集 120 例本院健康体检者作为对照组。纳入患者 MSCT、
TTE、血常规等相关结果，对病情严重程度进行综合评估。结果：①与正常对照组相比，PH组NLR、RDW及MSCT测量的主肺
动脉直径（diameters of the main pulmonary artery，dMPA）、主肺动脉与升主动脉内径比（ratio of main pulmonary artery to ascending
aorta diameter，rPA）及升主动脉内径值（ascending aortic diameter，AOD）明显升高，差异有统计学意义（P < 0.05）；②与轻度 PH
组相比，中重度PH组NLR、RDW 及dMPA、rPA明显升高，差异有统计学意义（P < 0.05）；③NLR、RDW 及dMPA、rPA与肺动脉
收缩压（systolic pulmonary artery pressure，PASP）呈正相关，AOD与PASP无相关性；④NLR、RDW 及 dMPA、rPA 对 PH 严重程度
有较好的预测价值；⑤RDW、dMPA 为 PASP 升高的危险因素。结论：对于PH的病情评估，NLR、RDW、dMPA及rPA 均具有较
高的预测价值，可作为评估患者病情严重程度的指标；RDW、dMPA被证实为PH患者病情加重的危险因素。
［关键词］ 肺高压；红细胞分布宽度；中性粒细胞淋巴细胞比值；多层螺旋CT；严重程度
［中图分类号］ R543.2 ［文献标志码］ A ［文章编号］ 1007⁃4368（2023）01⁃079⁃05
doi：10.7655/NYDXBNS20230112

Evaluation of severity of pulmonary hypertension by NLR and RDW combined with
multislice spiral CT

SHI Yangyang，QIAN Jun，SHI Xinwei，SUN Kai *
Emergency Department，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［Abstract］ Objective：To analyze the clinical characteristics of patients with pulmonary hypertension（PH）according to neutrophil/
lymphocyte ratio（NLR）and red cell distribution width（RDW）combined with multislice spiral CT（MSCT），and to explore the
correlation between the clinical characteristics and the severity of disease. Methods：The clinical data of 124 patients with PH
assessed by transthoracic echocardiography（TTE）in the First Affiliated Hospital of Nanjing Medical University from August 2018 to
February 2022 were collected as PH group，and data of 120 healthy patients in our hospital during the same period were collected as
control group. MSCT，TTE，blood routine examination and other related results were included to comprehensively evaluate the severity
of the disease. Results：①Compared with normal control group，NLR，RDW and diameters of the main pulmonary artery（dMPA），ratio
of main pulmonary artery to ascending aorta diameter（rPA） and ascending aortic diameter（AOD） measured by MSCT were
significantly increased in PH group，and the differences were statistically significant（P < 0.05）. ②Compared with the mild PH group，
the NLR，RDW，dMPA and rPA were significantly higher in the moderate and severe PH group，and the differences were statistically
significant（P < 0.05）. ③The NLR，RDW，dMPA and rPA were positively correlated with systolic pulmonary artery pressure（PASP），
while AOD had no correlation with PASP. ④The NLR，RDW，dMPA and rPA measured by MSCT had better predictive value for the
severity of PH. ⑤RDW，dMPA were the risk factors for elevated PASP. Conclusion：For the assessment of the severity of PH，NLR，
RDW，dMPA and rPA all have high predictive value，these indicators can be used as common indicators to evaluate the severity of
patients’disease. RDW，dMPA are confirmed to be independent predictors of the exacerbation of PH patients.

［基金项目］ 国家自然科学基金（81871544）；江苏省科技厅基础研究计划（自然科学基金）（BK20181493）
∗
通信作者（Corresponding author），E⁃mail：sunkai@njmu.edu.cn