血小板淋巴细胞比值对老年高血压患者左心室舒张功能不全的预测价值

Value of platelet/lymphocyte ratio for predicting left ventricular diastolic dysfunction in elderly hypertensive patients

目的探讨血小板/淋巴细胞比值(PLR)对老年高血压患者左心室舒张功能不全(LVDD)的预测价值。方法选择就诊于我院心脏内科的老年原发性高血压患者536例,根据诊断分为LVDD组334例和非LVDD组202例;收集患者的临床基线资料和超声心动图指标,计算二尖瓣舒张早期最大血流速度(E峰)/舒张晚期最大血流速度(A峰)比值。结果与非LVDD组比较,LVDD组年龄、女性、收缩压、白细胞计数、PLR及A峰明显升高,而淋巴细胞、E峰、E/A比值明显降低,差异有统计学意义(P<0.05,P<0.01)。PLR、年龄、女性、收缩压为老年高血压患者LVDD的独立危险因素(P<0.05)。PLR预测老年高血压患者LVDD的ROC曲线下面积为0.710(95%CI:0.663~0.757,P<0.01),敏感性为74.3%,特异性为61.7%。结论PLR是老年高血压患者LVDD的独立危险因素,PLR可能有助于及早且准确地发现LVDD。

Objective To study the value of PLR for predicting LVDD in elderly hypertensive patients.Methods Five hundred and thirty-six elderly hypertensive patients were divided into LVDD group(n=334)and LVDD-free group(n=202).Their baseline clinical data and echocardiographic parameters were recorded.The ratio of peak mitral annular early diastolic velocity(peak E)to peak mitral annular late diastolic velocity(peak A)was calculated.Results The age was significantly older,the number of females was significantly greater,the SBP,number of white blood cells,PLR and peak A were significantly higher while the number of lymphocytes was significantly smaller,the peak E and E/A ratio were significantly lower in LVDD group than in LVDD-free group(P<0.05,P<0.01).The PLR,age,females and SBP were independent risk factors for LVDD in elderly hypertensive patients(P<0.05).ROC curve analysis displayed that the AUC for PLR in predicting the LVDD in elderly hypertensive patients was 0.710(95%CI:0.663-0.757,P<0.01)with a sensitivity of 74.3%and a specificity of 61.7%.Conclusion PLR is an independent risk factor for LVDD in elderly hypertensive patients and contributes to the early and accurate identification of their LVDD.