摘要
目的探讨血清中性粒细胞与淋巴细胞比值(NLR)、胱抑素C(CysC)、体质指数(BMI)与慢性心力衰竭(CHF)患者心功能的相关性及其在不良预后中的应用价值。方法纳入2019年8月至2020年8月就诊于北京航天总医院心血管内科的120例CHF患者,收集CHF患者临床资料,根据美国纽约心脏病学会(NYHA)心功能分为Ⅱ级组(37例)、Ⅲ级组(47例)和Ⅳ级组(36例);另根据是否发生主要心血管不良事件(MACE)分为MACE组(36例)、无MACE组(84例)。比较不同心功能分级及不同预后CHF患者血清NLR、CysC水平以及BMI水平,采用有序多分类回归分析CHF患者心功能分级影响因素,采用Spearman相关分析上述指标与CHF患者心功能分级相关性,并采用受试者工作特征曲线(ROC曲线)分析上述指标对CHF患者不良预后的预测价值。结果心功能Ⅳ级组患者血清NLR、CysC水平以及BMI水平高于Ⅲ级组患者高于Ⅱ级组患者(P<0.05)。MACE组患者血清NLR、CysC水平明显高于无MACE组患者,而BMI明显低于无MACE组患者(P<0.05)。有序多分类回归分析结果显示,NLR、CysC、BMI均为CHF患者心功能影响因素(P<0.05)。Spearman相关分析显示,血清NLR、CysC水平以及BMI水平与CHF患者心功能分级均呈显著正相关(P<0.01)。ROC曲线显示,NLR(AUC=0.750,P<0.01)、CysC(AUC=0.761,P<0.01)以及BMI(AUC=0.747,P<0.01)对CHF患者不良预后具有一定预测价值,且三项联合(AUC=0.923,P<0.01)预测价值较高。结论血NLR、CysC、BMI水平与CHF患者心功能呈正相关,联合检测三项指标可提高对CHF患者不良预后预测价值。
Objective To investigate the correlation among neutrophil/lymphocyte ratio(NLR),cystatin C(CysC),body mass index(BMI)and heart function and its application value to poor prognosis in patients with chronic heart failure(CHF).Methods CHF patients(n=120)were chosen from Department of Cardiovascular Medicine in Beijing Aerospace General Hospital from Aug.2019 to Aug.2020,and their clinical materials were collected.According to NYHA classification,the patients were divided into grade II group(n=37),gradeⅢgroup(n=47)and gradeⅣgroup(n=36).In addition,the patients were divided,according to whether or not MACE occurred,into MACE group(n=36)and non-MACE group(n=84).The levels of NLR,CysC and BMI were compared among all groups.The influence factors of NYHA classification were analyzed by using ordered multi-class regression analysis.The correlation among above indexed and NYHA classification was analyzed by using Spearman correlation analysis.The predictive value of above indexes to poor prognosis was analyzed by using receiver operating characteristic(ROC)curve.Results The levels of NLR,CysC and BMI were higher in grade IV group than those in gradeⅢgroup and gradeⅡgroup(P<0.05).The levels of NLR and CysC were significantly higher,and BMI level was significantly lower in MACE group than those non-MACE group(P<0.05).The results of ordered multi-class regression analysis showed that NLR,CysC and MI were all influence factors of heart function in CHF patients(P<0.05).The results of Spearman correlation analysis showed that levels of NLR,CysC and BMI were positively correlated significantly to heart function classification in CHF patients(P<0.01).The results of ROC curve analysis showed that NLR(AUC=0.750,P<0.01),CysC(AUC=0.761,P<0.01)and BMI(AUC=0.747,P<0.01)had some predictive value,and combination of them had higher predictive value(AUC=0.923,P<0.01)to poor prognosis in CHF patients.Conclusion The levels of NLR,CysC and BMI are positively correlated to heart function,and combination of them can promote the predictive
作者
王婷婷
彭伟
王进
Wang Tingting;Peng Wei;Wang Jin(Department of Cardiovascular Medicine,Beijing Aerospace General Hospital,Beijing 100076,China;不详)
出处
《中国循证心血管医学杂志》
2022年第8期979-982,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
北京市科技计划课题(Z171100001017243)。
