摘要
目的探讨老年心力衰竭(heartfailure,HF)患者中性粒细胞与HDL-C比值(neutrophil-to-HDL-Cratio,NHR)与心功能的关系。方法选取2019年1月1日至2022年2月28日河北省人民医院心血管内科住院的老年HF患者121例,根据不同HF分为射血分数减低的心力衰竭(HFrEF)组51例和射血分数保留的心力衰竭(HFpEF)组70例;选取同期因其他疾病入院的老年住院患者82例作为对照组。比较3组白细胞计数、中性粒细胞、红细胞计数和血小板计数,生化全项中的白蛋白、丙氨酸转氨酶、天冬氨酸转氨酶、TG、TC、HDL-C、空腹血糖以及心脏超声中LVEF等相关指标。结果3组男性、螺内酯、β受体阻滞剂、钙离子通道阻滞剂、高血压、他汀类药物、白蛋白、TC、TG、HDL-C、红细胞计数、中性粒细胞、NHR和LVEF比较,差异有统计学意义(P<0.05,P<0.01)。HFpEF组和HFrEF组NHR较对照组明显升高,差异有统计学意义(P<0.05)。Spearman相关性分析显示,NHR与红细胞计数呈正相关,与白蛋白、TC、HDL-C、LVEF呈负相关(P<0.05,P<0.01);LVEF与白蛋白、TC、HDL-C呈正相关(P<0.01)。二元logistic回归分析显示,TC(OR=0.356,95%CI:0.149~0.850,P<0.05)、红细胞计数(OR=0.373,95%CI:0.150~0.927,P<0.05)、NHR(OR=1.499,95%CI:1.081~2.078,P<0.05)、LVEF(OR=0.865,95%CI:0.815~0.919,P<0.01)是HF的独立影响因素。NHR预测HF的ROC曲线下面积为0.706(95%CI:0.635~0.778),敏感性为62.0%,特异性为73.2%。结论NHR在诊断HF方面具有一定的作用。
Objective To investigate the relationship between neutrophil-to-HDL-C ratio(NHR)and cardiac function in elderly patients with heart failure(HF).Methods One hundred and twenty-one elderly HF patients hospitalized in the Department of Cardiovascular Medicine of Hebei Provincial People's Hospital from January 1,2019 to February 28,2022 were selected and divided into HF with reduced ejection fraction(HFrEF)group(n=51)and with preserved ejection fraction(HFpEF)group(n=70).Another 82 elderly hospitalized patients admitted due to other diseases in the same period were enrolled as the control group.The white blood cell count,neutrophil count,red blood cell count and platelet count,levels of albumin,alanine aminotransferase,aspartate aminotransferase,TG,TC,HDL-C and fasting glucose,LVEF in cardiac ultrasound and other related indexes were compared among the 3 groups.Results There were statistical differences in male ratio,spironolactone,β-blocker,calcium channel blocker,hypertension,use of statins,albumin,TC,TG,HDL-C,red blood cell count,neutrophils,NHR and LVEF among the 3 groups(P<0.05,P<0.01).NHR was significantly higher in the HFpEF and HFrEF groups than the control group(P<0.05).Spearman correlation analysis showed that NHR was positively correlated with the red blood cell count,but negatively correlated with albumin,TC,HDL-C and LVEF(P<0.05,P<0.01);LVEF was positively correlated with albumin,TC and HDL-C(P<0.01).Binary logistic regression analysis indicated that TC(OR=0.356,95%CI:0.149-0.850,P<0.05),red blood cell count(OR=0.373,95%CI:0.150-0.927,P<0.05),NHR(OR=1.499,95%CI:1.081-2.078,P<0.05)and LVEF(OR=0.865,95%CI:0.815-0.919,P<0.01)were independent influencing factors of HF.The AUC value of NHR in predicting HF was 0.706(95%CI:0.635~0.778),with a sensitivity of 62.0%and a specificity of 73.2%.Conclusion NHR plays a role in the diagnosis of HF.
作者
杨玉亭
左庆娟
郭艺芳
Yang Yuting;Zuo Qingjuan;Guo Yifang(Graduate School of Hebei Medical University Shijiazhuang 050000,Hebei Province China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2023年第7期688-691,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
