杜鑫，季春鹏，张莹，施继红，黄喆，朱辰蕊，李慧英，魏晓明，林黎明，熊海亮，刘妍，吴寿岭



炎症因子对全因死亡的预测价值研究：开滦集团8.3万职工6.9年随访结果

杜鑫，季春鹏，张莹，施继红，黄喆，朱辰蕊，李慧英，魏晓明，林黎明，熊海亮，刘妍，吴寿岭

摘要

关键词白细胞；中性粒细胞；淋巴细胞；C反应蛋白质；死亡原因

作者单位：063000河北省唐山市，华北理工大学附属开滦总医院 心内二科（杜鑫、季春鹏、施继红、黄喆、朱辰蕊、李慧英、魏晓明、林黎明、熊海亮、刘妍，吴寿岭），华北理工大学附属医院 超声科（张莹）

Predictive Value of Inflammatory Factors on All Cause Mortality in Normal Population:6.9 Years Follow-up Results in Kailuan Group for 83,000 Subjects

DU Xin,JI Chun-peng,ZHANG Ying,SHI Ji-hong,HUANG Zhe,ZHU Chen-rui,LI Hui-ying,WEI Xiao-ming,LIN Li-ming,
XIONG Hai-liang,LIU Yan,WU Shou-ling.
Department of Cardiology Second Unit,Kailuan General Hospital,Tangshan(063000),Hebei,China
Corresponding Author:WU Shou-ling,Email:drwusl@163.com

Abstract

Objective:To explore the predictive value of inflammatory factors on all cause mortality in normal population.

Methods:In our prospective cohort study,a total of 83,228 subjects from physical examination of Kailuan group from 2006-07 to 2007-10 were enrolled,nobody had acute inflammation.The death information was collected once per year and the last follow-up was conducted in 2013-12-31.According to baseline levels,white blood cells(WBC),ratio of neutrophil/lymphocyte ratio(N/L)and C-reactive protein(CRP)were respectively divided into 4 Quartile groups;all cause mortality was compared among different groups and their risks were studied by multi-Cox regression analysis.

Results:The average follow-up time was 6.9 years.All cause mortality in Quartile 1,Quartile 2,Quartile 3 and Quartile 4 groups for WBC were 4.2%,4.5%,4.5% and 5.0% respectively;for N/L were 3.3%,3.6%,4.5% and 6.7% respectively;for CRP were 3.0%,3.6%,4.8% and 6.8% respectively.Multi-Cox regression analysis indicated that with adjusted age,gender,waist and other confounders,by elevation of WBC,N/R and CRP,the risks of all cause mortality were increased accordingly,and the risks in Quartile 4 groups were higher than those in Quartile 1 groups as for WBC,it was 1.17-time(95% CI 1.06-1.29);for N/L,it was 1.44-time(95% CI 1.31-1.59);for CRP,it was 1.33-time(95% CI 1.20-1.47)respectively.

Conclusion:Elevated WBC,N/R and CRP are independent risk factors for all cause mortality in normal population.

Key words Leukocytes;Neutrophils;Lymphocytes;C-reactive protein;Cause of death

(Chinese Circulation Journal,2016,31:245.)

近年来，国外有大量研究发现，慢性炎症反应可能增加远期心、脑、肿瘤原性死亡和全因死亡风险[1-4]。作为非特异性炎症反应的标志物，白细胞计数（WBC）与C反应蛋白（CRP）已被证实与全因死亡相关[4-7]，特别是在糖尿病、外周动脉闭塞性疾病、急性失代偿性心力衰竭和冠状动脉旁路移植术后的患者中，WBC和CRP是全因死亡的独立预测因子[8-14]。另外，最近的研究也发现，白细胞的某些亚组分对评估冠心病患者全因死亡风险有较高的预测价值，其中以中性粒细胞与淋巴细胞比率（NLR）的价值最高[12]。但目前国内鲜有关于以上炎症标志物对一般人群生存影响的前瞻性队列研究报道，为此，本研究利用开滦研究资料（ChiCTR-TNC-1100 1489），分析了WBC、NLR、CRP对一般人群全因死亡风险的预测价值。

1　对象与方法

研究对象：2006-07至2007-10，由开滦总医院、开滦林西医院、开滦赵各庄医院、开滦唐家庄医院、开滦范各庄医院、开滦吕家坨医院、开滦荆各……