血清胱抑素C、红细胞分布宽度对急性心力衰竭短期死亡风险的预测价值

Predictive value of serum cystatin C and red blood cell distribution width in the risk of short-term death in acute heart failure

目的探讨血清胱抑素C、红细胞分布宽度对急性心力衰竭短期死亡风险的预测价值。方法回顾性分析2019年4月—2021年10月本院收治的153例急性心力衰竭患者的临床资料,根据28 d内预后情况将患者分为存活组126例和死亡组27例,比较2组患者基线临床资料和实验室指标;应用logistic回归分析患者短期死亡的影响因素,应用受试者工作特征曲线(ROC)分析实验室指标预测短期死亡的价值。结果死亡组患者年龄、心率、心房颤动患病率显著高于存活组(P<0.05),收缩压、LVEF显著低于存活组(P<0.05);死亡组患者C-反应蛋白、红细胞分布宽度、血小板计数、血肌酐、尿素氮、胱抑素C、BNP水平显著高于存活组(P<0.05);logistic回归分析显示,年龄、LVEF、SOFA评分、心房颤动、红细胞分布宽度、胱抑素C、BNP是影响患者短期死亡的主要因素(P<0.05);ROC曲线分析显示,红细胞分布宽度、胱抑素C、BNP预测患者短期死亡的AUC分别为0.781、0.766、0.789,三者比较差异无统计学意义(P>0.05)。结论血清胱抑素C、红细胞分布宽度升高是急性心力衰竭患者院内死亡的独立危险因素,在预测短期死亡风险方面有潜在应用价值。

Objective To investigate the predictive value of serum cystatin-C and red blood cell distribution width on the risk of short-term death in acute heart failure.Methods Clinical data of 153 patients with acute heart failure admitted to our hospital from April 2019 to October 2021 were retrospectively analyzed,patients were divided into the survival group(n=126)and the death group(n=27)according to the prognosis within 28 days,and the baseline clinical data and laboratory indicators of the two groups were compared.Logistic regression was used to analyze the influencing factors of short-term death,and receiver operating characteristic curve(ROC)was used to analyze the value of laboratory indicators in predicting short-term death.Results Age,heart rate and the prevalence of atrial fibrillation in death group were significantly higher than those in survival group(P<0.05),while systolic blood pressure and LVEF were significantly lower than those in survival group(P<0.05).The levels of C-reactive protein,red blood cell distribution width,platelet count,serum creatinine,blood urea nitrogen,cystatin-C and BNP in death group were significantly higher than those in survival group(P<0.05).Logistic regression analysis showed that age,LVEF,SOFA score,atrial fibrillation,red blood cell distribution width,cystatin C and BNP were the main factors affecting short-term death(P<0.05).ROC curve analysis showed that the AUC of RBC distribution width,Cystatin-C and BNP in predicting short-term death were 0.781,0.766 and 0.789,respectively,and the differences were not statistically significant(P>0.05).Conclusion Serum cystatin-C and increased RBC distribution width are independent risk factors for nosocomial death in patients with acute heart failure,and have potential application value in predicting short-term death risk.