血清NLR和PLR及MPVLR在慢性心力衰竭患者中的临床意义

Clinical significance of serum NLR,PLR and MPVLR in patients with chronic heart failure

目的基于倾向性评分匹配分析血清中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、平均血小板体积与淋巴细胞比值(MPVLR)与慢性心力衰竭(CHF)发生的关系。方法收集2021年1-12月新疆医科大学第一附属医院收治的CHF患者247例作为CHF组,另选择同期体检的健康人群260名作为对照组。采用倾向性评分匹配法将两组进行配对,比较匹配后两组NLR、PLR、MPLR水平;采用logistic回归分析CHF发生的危险因素,受试者工作特征(ROC)曲线分析NLR、PLR、MPVLR预测CHF的诊断价值。结果共匹配成功100对,匹配后CHF组NLR为(2.74±1.66)、PLR为(148.42±86.80)、MPVLR为(6.85±3.76),对照组NLR为(1.49±0.45)、PLR为(115.73±33.05)、MPVLR为(5.24±1.42),CHF组上述指标均显著高于对照组,差异均有统计学意义(t=-7.258、-3.519、-3.998,P均<0.001)。CHF组患者NLR、PLR、MPVLR水平随着纽约心功能分级(NYHA)增加而升高(t=-4.125、-3.007、-4.147,P均<0.01)。ROC曲线分析NLR、PLR、MPVLR及三者联合诊断CHF曲线下面积分别为0.820(0.762~0.878)、0.614(0.536~0.692)、0.609(0.531~0.688)、0.832(0.775~0.889)。多因素logistic回归分析发现NLR为CHF发生的独立危险因素(P<0.01)。结论NLR、PLR、MPVLR与CHF的发生相关。NLR为CHF发生的独立危险因素。

Objective To analyze the relationship between diagnosis of chronic heart failure(CHF)and serum neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),mean platelet volume to lymphocyte ratio(MPVLR)based on propensity score matching.Methods A total of 247 patients with CHF admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2021 to December 2021 were retrospectively collected as the CHF group,and 260 healthy people were selected as the control group who underwent physical examination in our hospital during the same period.Propensity score matching was used to match the two groups,and the levels of NLR,PLR and MPLR were compared between the two groups after matching.The independent risk factors of CHF were analyzed by multivariate logistic regression;the diagnostic value of NLR,PLR and MPVLR in predicting CHF were determined by constructing receiver operating characteristic curve.Results A total of 100 pairs were matched successfully.After matching,the levels of NLR(2.74±1.66),PLR(148.42±86.80)and MPVLR(6.85±3.76)in CHF group were significantly higher than those in control group(1.49±0.45),(115.73±33.05),(5.24±1.42).The differences were statistically significant(t=-7.258,-3.519,-3.998;all P<0.01).The levels of NLR,PLR and MPVLR in CHF group were increased with the increase of New York cardiac function scale(NYHA)(t=-4.125,-3.007,-4.147;all P<0.01).The area under the curve of NLR,PLR,MPVLR and their combination to predict CHF were 0.820(0.762-0.878),0.614(0.536-0.692),0.609(0.531-0.688)and 0.832(0.775-0.889),respectively.Multivariate logistic regression analysis showed that NLR was an independent risk factor for CHF(P<0.01).Conclusions NLR,PLR and MPVLR were related to the diagnosis of CHF.NLR was an independent risk factor for CHF.