Changes Of Lymphocyte Neutrophil Ratio In Patients With Chronic Kidney Disease Complicated With Acute ST Segment Elevation Myocardial Infarction And Its Effect On Prognosis

Purpose: To analyze the changes of lymphocyte to neutrophil ratio（NLR）in patients with chronic kidney disease（CKD）complicated with acute ST segment elevation myocardial infarction（STEMI）and its effect on the prognosis of patients.Method: 1304 patients with acute ST segment elevation myocardial infarction who underwent emergency PCI in China Japan Friendship Hospital of Jilin University from December 2019 to December 2020 were selected.After screening by inclusion criteria and exclusion criteria,263 patients were selected.The clinical data of these patients were collected and NLR and EGFR were calculated.They were divided into ckd1 group（renal injury index（+）and ≥ 90 ml / min · 1.73m2）according to different estimated glomerular filtration rate（EGFR）Ckd2 group（60 90 ml / min · 1.73m2）,ckd3 group（30 60 ml / min · 1.73m2）,ckd4 5 group（< 30 ml / min · 1.73m2）,and control group（no CKD group）.SPSS 20.0 was used for statistical analysis to compare the ratio of neutrophils to lymphocytes and the incidence of major adverse cardiovascular events（MACE）,and the correlation between NLR level and mace incidence in all patients was tested.The test methods were statistically significant（P < 0.05）.Result: 1.After screening by inclusion criteria and exclusion criteria,there were 263 patients,including 161 males and 102 females,aged 27 90 years,with an average age of 55 ± 11.7 years.According to Egfr,there were 79 cases in CKD1 group（mean NLR 3.22 ± 0.59）,70 cases in CKD2 group（mean NLR 3.37 ± 0.53）,44 cases in CKD3 group（mean NLR 4.15 ± 0.62）,20 cases in CKD4 5 group（mean NLR 5.22 ± 0.60）and 50 cases in control group（mean NLR 2.77 ± 0.45）.2.Comparison of NLR level: the difference of NLR level between each group and the control group was statistically significant.Except that there was no significant difference in NLR level between CKD1 group and CKD2 group,the difference of NLR level between CKD3 group and CKD2 group,CKD4 5 group and CKD3 group was statistically significant（P < 0.05）.3.Comparison of mace incidence: there was significant difference in mace incidence between each group and the control group（P < 0.05）.Except that there was no significant difference in mace incidence between CKD1 group and CKD2 group,the mace incidence in CKD3 group was significantly higher than that in CKD2 group and CKD4 5 group and CKD3 group（P < 0.05）.4.Correlation test between NLR level and MACE: by Spearman correlation test,the correlation coefficient between NLR level and mace was 0.042 < 0.05,which was statistically significant.Conclusion: 1.In patients with acute ST segment elevation myocardial infarction,there is a correlation between CKD and CKD stage and high NLR level.2.The severity of CKD was correlated with the incidence of mace in patients with acute myocardial infarction.3.In patients with acute ST segment elevation myocardial infarction,high NLR level is associated with mace,which may be one of the mechanisms of CKD affecting the prognosis of these patients.