感染性心内膜炎患者RDW和NLR与凝血功能指标变化及其临床意义  

Changes and clinical significance of RDW,NLR and coagulation function indexes in patients with infective endocarditis

作　　者：张强[1] 张永恒[1] 刘建平[1] ZHANG Qiang;ZHANG Yong-heng;LIU Jian-ping(Department of Cardio-Vascular Surgery,Suining Central Hospital,Suining,Sichuan 629000,China)

机构地区：[1]遂宁市中心医院心脏大血管外科,四川遂宁629000

出　　处：《热带医学杂志》2022年第11期1543-1546,共4页Journal of Tropical Medicine

基　　金：四川省卫生和计划生育委员会课题(17PJ184)

摘　　要：目的探讨感染性心内膜炎(IE)患者红细胞分布宽度(RDW)、中性粒细胞/淋巴细胞比值(NLR)和凝血功能指标可溶性P-选择素(sP-SLT)水平变化及临床意义。方法收集2010年10月-2021年10月遂宁市中心医院收治的72例IE患者为IE组,并根据疾病转归分为预后良好组56例与预后不良组16例;另选取同期40名健康体检者作为对照组。检测受试对象外周静脉血C反应蛋白(CRP)以及sP-SLT水平;收集血常规结果包括淋巴细胞(LYM)、中性粒细胞(NEU)、RDW,并计算NLR,采用ROC曲线评价RDW、NLR、sP-SLT及CRP对IE患者预后的预测价值。结果IE组患者RDW、NLR及血清sP-SLT水平均高于对照组,差异有统计学意义(t=5.292、14.045、9.893,P均<0.001);预后不良组RDW、NLR及血清sP-SLT、CRP水平均高于预后良好组,差异有统计学意义(t=9.112、10.507、21.922、9.790,P均<0.001)。sP-SLT和NLR预测IE患者预后不良的AUC均大于CRP预测的AUC,差异有统计学意义(Z=3.231、2.030,P均<0.05),RDW和CRP预测IE患者预后不良的AUC比较差异无统计学意义(Z=1.429,P>0.05)。结论IE患者高RDW、NLR及血清sP-SLT水平与不良预后密切相关,其中NLR及血清sP-SLT对预后的预测价值高于CRP。Objective To explore the changes and clinical significance of red blood cell distribution width(RDW),neutrophil/lymphocyte ratio(NLR)and coagulation function index[soluble P-selectin(s P-SLT)]in patients with infective endocarditis(IE).MethodsA total of 72 patients with IE admitted to the hospital were enrolled as IE group between October 2010 and October 2021.According to disease outcomes,they were divided into good prognosis group(56 cases)and poor prognosis group(16 cases).A total of 40 healthy controls during the same period were enrolled as control group.The levels of peripheral blood C-reactive protein(CRP)and s P-SLT were detected.The results of blood routine were collected,including lymphocytes(LYM),neutrophils(NEU)and RDW.NLR was calculated.The predictive value of RDW,NLR,s P-SLT and CRP for prognosis of IE patients was evaluated by ROC curves.ResultsThe levels of RDW,NLR and serum s P-SLT in IE group were significantly higher than those in control group(t=5.292,14.045,9.893,all P<0.001).The levels of RDW,NLR,serum s P-SLT and CRP in poor prognosis group were significantly higher than those in good prognosis group(t=9.112,10.507,21.922,9.790,all P<0.001).AUC of s P-SLT and NLR for predicting poor prognosis of IE patients was significantly greater than that of CRP(Z=3.231,2.030,all P<0.05).There was no significant difference in AUC between RDW and CRP(Z=1.429,P>0.05).ConclusionsThe high levels of RDW,NLR and serum s PSLT were closely related to poor prognosis in IE patients.The prognostic value of NLR and serum s P-SLT was higher than that of CRP.

关 键 词：感染性心内膜炎 红细胞分布宽度 中性粒细胞/淋巴细胞比值 可溶性P-选择素 

分 类 号：R542.41[医药卫生—心血管疾病]