NLR及CRP/ALB比值与老年慢性心力衰竭短期预后的相关性分析

Correlation between NLR,CRP/ALB ratio and short-term prognosis in elderly patients with chronic heart failure

目的探讨中性粒细胞与淋巴细胞比值(NLR)及C反应蛋白与清蛋白比值(CRP/ALB)与老年慢性心力衰竭短期预后的相关性。方法回顾性收集2016年1-12月于该院心内科确诊并收住入院的老年慢性心力衰竭患者194例,按NYHA心功能分级指标将患者分为Ⅱ～Ⅳ组,入院24h内测定患者血常规、血浆N末端脑钠肽前体(NT-proBNP)、CRP、ALB及尿酸(UA)水平,计算NLR及CRP/ALB。采用相关性分析方法分析NLR、CRP/ALB与NT-proBNP、UA及NYHA之间的相关关系。再根据NLR的中位数,以NLR>3.5、患者住院时间、NT-proBNP、UA、CRP/ALB作为变量进入心因性不良事件的多元回归模型中。结果随着NYHA分级的升高,患者的NLR、CRP/ALB、lgNT-proBNP、住院时间及UA也显著升高,差异有统计学意义(均P<0.05)。相关分析显示,NLR、CRP/ALB均与NT-proBNP、UA及NYHA分级呈正相关关系(均P<0.05)。在随访期间(随访中位数为11个月)的心因性不良事件多元回归模型中,NLR>3.5、UA是影响慢性心力衰竭患者短期预后不良的高危因素。结论 NLR、CRP/ALB随患者心功能分级的进展显著增加,且NLR的增加有可能导致患者预后不良。

Objective To investigate the correlation between neutrophil to lymphocyte ratio(NLR)and C-reactive protein to albumin ratio(CRP/ALB)and short-term prognosis in elderly patients with chronic heart failure.Methods Totally 194 elderly patients with chronic heart failure(CHF)admitted to our hospital from January to December 2016 were retrospectively collected.The patients were divided into two groups according to the NYHA cardiac function grading index.The blood routine,plasma N-terminal pro-brain natriuretic peptide(NT-proBNP),CRP,ALB and uric acid(UA)levels were measured within 24 hours after admission.Calculate NLR and CRP/ALB.Correlation analysis was used to analyze the correlation between NLR,CRP/ALB and NT-proBNP,UA and NYHA.According to the median of NLR,NLR>3.5,length of stay,NT-proBNP,UA and CRP/ALB were used as variables to enter the multivariate regression model of psychogenic adverse events.Results NLR,CRP/ALB,lgNT-proBNP,length of stay and UA were also significantly increased with the increase of NYHA classification(P<0.05).Correlation analysis showed that NLR and CRP/ALB were positively correlated with NT-proBNP,UA and NYHA grading(P<0.05).NLR>3.5 and UA were high risk factors for poor short-term prognosis in the multivariate regression model of psychogenic adverse events during follow-up(median follow-up was 11 months).Conclusion The levels of NLR and CRP/ALB increased significantly with the progress of cardiac function classification,and the increase of NLR may lead to poor prognosis.