摘要
目的探讨中性粒细胞/高密度脂蛋白胆固醇比值(NHR)、单核细胞/高密度脂蛋白胆固醇比值(MHR)和淋巴细胞/高密度脂蛋白胆固醇比值(LHR)在慢性心力衰竭急性发作患者诊疗过程中的意义。方法选取2020年3月至2021年9月该院心内科收治的慢性心力衰竭急性发作患者310例作为研究对象。研究对象根据有无合并急性肾损伤分为肾损伤组和非肾损伤组;又根据出院后6个月有无发生主要心血管不良事件(MACE)分为预后不良组和预后良好组。分别于入院后24 h、3 d检测血常规、血脂、肾功能、N末端B型脑钠尿肽(NT-proBNP)、可溶性肿瘤因子2抑制剂(sST2)水平;计算NHR、MHR、LHR和估算肾小球滤过率(eGFR)。于入院后24 h、3 d时测定左心室射血分数(LVEF),出院后6个月随访MACE发生情况。结果入院后24 h,肾损伤组、预后不良组NHR、MHR、LHR、sST2、NT-proBNP分别高于非肾损伤组、预后良好组,LVEF分别低于非肾损伤组、预后良好组,差异有统计学意义(P<0.05);BUN、Scr、eGFR两组间比较差异无统计学意义(P>0.05);入院后3 d,肾损伤组、预后不良组NHR、MHR、LHR、sST2、NT-proBNP、BUN、Scr分别高于非肾损伤组、预后良好组,LVEF、eGFR分别低于非肾损伤组、预后良好组,差异有统计学意义(P<0.05);入院后3 d,肾损伤组、预后不良组BUN、Scr高于入院后24 h,eGFR低于入院后24 h,差异有统计学意义(P<0.05)。相关分析结果:慢性心力衰竭急性发作患者NHR、MHR、LHR与NT-proBNP呈正相关(r=0.893,P=0.001;r=0.845,P=0.001;r=0.932,P=0.001);与eGFR呈负相关(r=-0.867,P=0.001;r=-0.736,P=0.001;r=-0.803,P=0.007)。Logistic回归分析显示,入院后24 h NHR、MHR、LHR升高的慢性心力衰竭急性发作患者并发急性肾损伤的危险性增加。受试者工作特征曲线结果显示,NHR、MHR、LHR联合检测的曲线下面积为0.826,对慢性心力衰竭急性发作患者发生MACE的预测价值最大。结论NHR、MHR、LHR联
Objective To explore the significance of neutrophil/high density lipoprotein cholesterol ratio(NHR),monocyte/high density lipoprotein cholesterol ratio(MHR),and lymphocyte/high density lipoprotein cholesterol ratio(LHR)in the diagnosis and treatment of patients with acute attack of chronic heart failure.Methods A total of 310 patients with acute attack of chronic heart failure admitted to the department of cardiology of a hospital from March 2020 to September 2021 were selected as the research objects.It was divided into kidney injury group and non-kidney injury group according to the presence or absence of combined acute kidney injury.The adverse prognosis group and the good prognosis group were divided according to the presence of major cardiovascular adverse events(MACE)at 6 months after discharge.The levels of blood routine,blood lipid,kidney function,NT-proBNP,soluble tumor factor 2 inhibitor(sST2)were measured at 24 h and 3 d after admission;NHR,MHR,LHR and estimated eGFR were calculated.At 24 h and 3 d after admission,the left ventricular ejection fraction(LVEF)was measured,and the major adverse cardiovascular events(MACE)was followed up 6 months after discharge.Results At 24 h after admission,the NHR,MHR,LHR,sST2,NT-proBNP of the kidney injury group and the adverse prognosis group were higher than those of the non-kidney injury group and the good prognosis group,and the LVEF was lower than those of the non-kidney injury group and the good prognosis group,and the differences were statistically significant(P<0.05).There was no significant difference in BUN,Scr and eGFR between the two groups(P>0.05).At 3 d after admission,the NHR,MHR,LHR,sST2,NT-proBNP,BUN and Scr of the kidney injury group and the adverse prognosis group were higher than those of the non-kidney injury group and the good prognosis group,and the LVEF and eGFR were lower than those of the non-kidney injury group and the good prognosis group,and the differences were statistically significant(P<0.05).At 3 d after admission,BUN and Scr of kidney
作者
李敬
孙红春
高茜
岳国栋
李英
LI Jing;SUN Hongchun;GAO Qian;YUE Guodong;LI Ying(Department of Cardiology,Hengshui People′s Hospital,Hengshui,Hebei 053000,China)
出处
《检验医学与临床》
CAS
2022年第21期2911-2915,2921,共6页
Laboratory Medicine and Clinic
基金
2021年河北省衡水市科学技术局科研基金项目(2021014092Z)。
