NLR与CysC在老年慢性心衰合并肾功能不全患者中的表达及意义

Expression and clinical significance of NLR and CysC in elderly patients with chronic heart failure complicated with renal insufficiency

目的 研究中性粒细胞与淋巴细胞比值(NLR)及胱抑素C(CysC)在慢性心力衰竭合并肾功能不全患者中表达变化及意义。方法 选取我院2019年12月至2021年12月收治的100例老年慢性心力衰竭患者,根据肾小球滤过率(eGFR)分为重度组[≤60ml/(min·1.73m^(2)),n=31]、轻度组[60~90ml/(min·1.73m^(2)),n=47]、正常组[≥90ml/(min·1.73m^(2)),n=22]。统计三组年龄、性别、基础心脏病、氨基末端脑钠肽前体(NT-proBNP)、左心室射血分数(LVEF)及心功能分级[纽约心脏病协会(NYHA)心功能分级]等一般资料,分析三组肾功能指标[eGFR、血肌酐(Scr)、尿素氮(BUN)]水平,比较三组血清CysC、NLR,分析慢性心力衰竭合并肾功能不全患者NLR、CysC水平与eGFR的相关性。结果 三组年龄、性别所占比、基础心脏病所占比、LVEF水平、NT-proBNP水平及NYHA分级所占比比较差异无统计学意义(P>0.05)。重度组eGFR低于轻度组与正常组(P<0.05),BUN、Scr水平均高于轻度组与正常组(P<0.05);轻度组eGFR低于正常组(P<0.05),BUN、Scr水平均高于正常组(P<0.05)。重度组CysC、NLR水平高于轻度组与正常组(P<0.05),轻度组CysC、NLR水平高于正常组(P<0.05)。经Pearson检验,慢性心力衰竭合并肾功能不全患者CysC、NLR水平与eGFR呈负相关(P<0.01)。结论 NLR及CysC水平与慢性心力衰竭合并肾功能不全患者eGFR相关,NLR及CysC水平越高,eGFR越低,呈负相关。

Objective To investigate the expression changes and significance of neutrophil to lymphocyte ratio(NLR)and cystatin C(CysC)in patients with chronic heart failure complicated with renal insufficiency.Methods 100 elderly patients with chronic heart failure admited to our hospital from December 2019 to December 2021 were selected and divided into severe group[≤60ml/(min·1.73m^(2)),n=31]and mild group[60~90ml/(min·1.73m^(2))according to glomerular filtration rate(eGFR).n=47],normal group[≥90ml/(min·1.73m^(2)),n=22].General data such as age,sex,basic heart disease,amino terminal brain natriuretic peptide preform(NT-proBNP),left ventricular ejection fraction(LVEF)and cardiac function classification[New York Heart Association(NYHA)cardiac function classification Jof the three groups were analyzed.The levels of renal function indicators[eGFR,blood creatinine(Scr),urea nitrogen(BUN)Jof the three groups were analyzed.Serum CysC and NLR were compared among the three groups to analyze the correlation between the levels of NLR and CysC and eCFR in patients with chronic heart failure complicated with renal insufficiency.Results There was no significant difference in the proportion of age,sex,basic heart disease,LVEF level,NT-proBNP level and NYHA classification among the three groups(P>0.05).eGFR in severe group was lower than that in mild group and normal group(P<0.05),BUN and Scr levels were higher than those in mild group and normal group(P<0.05);eGFR in mild group was lower than that in normal group(P<0.05),BUN and Scr levels were higher than those in normal group(P<0.05).The levels of CysC and NLR in severe group were higher than those in mild group and normal group(P<0.05),and the levels of CysC and NLR in mild group were higher than those in normal group(P<0.05).Pearson test showed that CysC and NLR levels were negatively correlated with eGFR in patients with chronic heart failure combined with renal insufficiency(P<O.O1).Conclusion The level of NLR and CysC is correlated with eGFR in patients with chronic heart failure combined with renal insufficiency.The higher the level of NLR and CysC,the lower the eGFR,showing a negative correlation.