射血分数保留的老年心力衰竭病人血小板/淋巴细胞比值与左心室舒张功能的相关性分析

Relationship of platelet-to-lymphocyte ratio with left ventricular diastolic function in elderly patients with heart failure with preserved ejection fraction

目的研究射血分数保留的老年心力衰竭(HFpEF)病人血小板/淋巴细胞比值(PLR)与左心室舒张功能的相关性。方法共纳入53例老年HFpEF病人,依据二尖瓣口E峰流速与二尖瓣环舒张早期峰值速度比值(E/e′)将病人分为低E/e′组(E/e′<8)、中E/e′组(8≤E/e′≤14)及高E/e′组(E/e′>14),比较3组病人临床特征、生化指标及心脏超声等相关指标,分析PLR与左心室舒张功能E/e′的相关性。结果低、中、高E/e′组之间年龄、淋巴细胞计数(LY)及PLR差异有统计学意义(P<0.05),其他指标的差异无统计学意义(P>0.05)。Spearman相关分析显示,PLR与E/e′呈显著负相关(P<0.05);LY及年龄与E/e′呈显著正相关(P<0.05);左心室舒张末期内径(LVDd)及左心室收缩末期内径(LVDs)与PLR呈显著正相关(P<0.05)。简单线性回归分析显示,PLR对E/e′的影响有统计学意义(F=12.361,P=0.001),回归方程为E/e′=18.145-0.030×PLR。多元线性回归分析显示,PLR是E/e′的独立影响因素(b=-0.025,t=-2.401,P=0.020)。结论老年HFpEF病人PLR与左心室舒张功能密切相关,PLR越高,E/e′越低。

Objective To study the relationship between platelet-to-lymphocyte ratio(PLR)and left ventricular diastolic function in the elderly patients with heart failure with preserved ejection fraction(HFpEF).Methods A total of 53 elderly patients with HFpEF were enrolled.According to the transmitral flow velocities to mitral annulus tissue velocities ratio in early diastole(E/e′),the patients were divided into low E/e′group(E/e′<8),middle E/e′group(8≤E/e′≤14)and high E/e′group(E/e′>14).The clinical characteristics,biochemical indicators,cardiac ultrasound and other related indicators of these patients were detected and compared among the three groups.And the relationship between PLR and E/e′was analyzed.Results There were significant differences in age,lymphocyte count(LY)and PLR among the three groups(P<0.05),but there were no significant differences in other indicators among the three groups(P>0.05).Spearman correlation analysis showed that PLR was negatively correlated to E/e′(P<0.05);LY and age were positively correlated to E/e′(P<0.05).Left ventricular end-diastolic diameter and left ventricular end-systolic diameter had positive correlation with PLR(P<0.05).Simple linear regression analysis showed that PLR showed significant effect on E/e′(F=12.361,P=0.001),and the regression equation can be obtained as E/e′=18.145-0.030×PLR.Multiple linear regression analysis showed that PLR was an independent factor influencing E/e′(b=-0.025,t=-2.401,P=0.020).Conclusions PLR is closely related to the left ventricular diastolic function in the elderly patients with HFpEF.