| Objective: To investigate the relationship between the ratio of neutrophils to lymphocytes(NLR)and the distribution width of erythrocytes(RDW)and atrial fibrillation.Methods: 1.From December 2017 to October 2019,100 patients were selected from the Department of Cardiology of the first hospital of Handan city who were diagnosed as non valvular atrial fibrillation,and 100 patients who came to our hospital at the same time and diagnosed as sinus rhythm were randomly selected as the control group.The diagnostic standards of all the patients in the group were in line with the2014 ACC / AHA / ESC guide standards,and the gender of the patients was checked in detail Age,general clinical data,current medical history and previous medical history,vital signs of patients were collected,auscultation and pulse counting of heart rhythm and heart sound were performed,routine 12 lead ECG and dynamic ECG results were recorded in detail,fasting and venous blood were taken in the morning after admission,routine blood and biochemical indexes were collected in detail,and color Doppler echocardiography was performed to collect all items in detail Index: analyze the relationship between NLR,RDW and AF;2.Divide AF into paroxysmal AF group and persistent / permanent AF group,compare the differences of NLR and RDW between the two groups and analyze them;3 According to the results of cha2ds2-vasc,the risk of stroke in patients with AF was evaluated and estimated.The AF group was further divided into middle,low-risk and high-risk groups.The differences of NLR and RDW between the two groups were compared.Results:1.Sex,age,smoking history,cerebral infarction history,diabetes history,WBC,RBC,Hb,lym,TC,TG,HDL-C,LDL-C,alt,GST There was no significant difference in AST,CRE and SUA(P > 0.05);the incidence of hypertension in AF group was higher than that in control group(P < 0.05);NLR,RDW and neu in AF group were2.65 ± 0.87,13.88 ± 1.44%,4.62 ± 1.39,respectively;NLR,RDW and neu in control group were 2.35 ± 0.8,respectively 1.13.45% ± 1.35%,4.16 ± 1.27,the difference between the two groups was statistically significant(P < 0.05);there was no statistically significant difference in left ventricular end diastolic diameter(LVP),interventricular septal thickness(ivst),left posterior wall thickness(LVPWT),left ventricular ejectionfraction(LVEF)between the AF group and the control group(P > 0.05)3.75 ± 0.49,3.29 ± 0.19,with significant difference(P < 0.05);NLR,RDW and LAD were analyzed by linear correlation analysis.The results showed that NLR level was positively correlated with LAD(r = 0.697,P < 0.001),RDW level was positively correlated with LAD(r = 0.629,The mean values of NLR and RDW in AF group and control group were 2.51 and 13.44%,respectively.The exposure of NLR and RDW was greater than or equal to the mean,and the two indexes were related to AF(or = 1.987 and 3.734).The higher the level of NLR and RDW,the greater the probability of AF;the multiple index logistic regression analysis showed that: NLR,RDW and LAD It was an independent risk factor for AF(P < 0.05);the ROC curve area predicted by NLR for AF was 0.714,(95% CI: 0.643-0.784,P < 0.05),the sensitivity and specificity were 62%and 72%,respectively,and the best cut off value was 1.34;the ROC curve area predicted by RDW for AF was 0.737,(95% CI: 0.665-0.809,The sensitivity and specificity were 77% and 74%,respectively.The best cut off value was 1.51.2.Compared with the persistent / long-term persistent AF group,the NLR and RDW levels in the paroxysmal AF group were significantly lower than those in the persistent /long-term persistent AF group(P < 0.05).3.The risk of stroke in patients with AF showed that the level of NLR and RDW in high risk subgroup was significantly higher than that in low and medium risk subgroup(P < 0.05).Conclusion: NLR and RDW,as inflammatory factors,participate in the occurrence of atrial fibrillation and can independently predict the occurrence of atrial fibrillation.NLR,RDW and LAD have significant positive correlation.The occurrence and maintenance of atrial fibrillation may be due to the involvement of NLR and RDW in cardiac structural remodeling;2 The higher the values of NLR and RDW,the longer the duration of AF,and the higher the NLR and RDW in patients with persistent /permanent AF than in patients with paroxysmal AF;3.The risk of AF stroke is significantly related to the level of NLR and RDW,and the NLR and RDW in patients with high risk of stroke are significantly higher than those with low risk of stroke. |
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