中性粒细胞百分比与白蛋白比值对慢性心力衰竭急性加重患者30天死亡的预后价值  

Prognostic value of neutrophil percentage-to-albumin ratio on 30-day mortality in patients with acute decompensated heart failure

作　　者：赵江峰[1] 畅晓燕[2] 安明春 赵飞龙[1] ZHAO Jiangfeng;CHANG Xiaoyan;AN Mingchun;ZHAO Feilong(Department of Cardiovascular Medicine,The Frist Affiliated Hospital of He nan University of Science and Technology,Zhengzhou 471000,China)

机构地区：[1]河南科技大学第一附属医院心血管内科,471000 [2]河南科技大学第二附属医院心血管内科

出　　处：《心肺血管病杂志》2022年第12期1216-1220,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探索慢性心力衰竭急性加重患者中性粒细胞百分比与白蛋白比值(NPAR)与30d死亡的相关性,探究NPAR的预后价值。方法:本研究为回顾性研究。连续纳入河南科技大学第一附属医院2019年1月至2021年12月,因慢性心力衰竭急性发作的222例住院患者。根据纳入患者的NPAR的中位数(1.78)进行两等分组,分为低NPAR组(NPAR<1.78)和高NPAR组(NPAR≥1.78),比较两组患者的临床数据差异,并收集随访数据。采用单因素Logistic回归计算分析心力衰竭30d死亡的危险因素,采用多因素Logistic回归模型分析NPAR与30d死亡的相关性,采用受试者工作特征(ROC)曲线分析和曲线下面积(AUC)评估NPAR对30d死亡的预测效能。结果:发现高NPAR组的患者年龄更大、心率更快,女性比例更高,合并2型糖尿病史和美国纽约心脏病学会心功能分级IV级的比例更高,WBC、中性粒细胞计数、中性粒细胞比例、FBG、血肌酐、脑钠肽、hs-CRP应蛋白水平更高。多因素回归分析发现高NPAR与慢性心力衰竭急性发作患者的30d死亡风险增加独立正相关(OR=2.41,95%CI:1.07~8.43)。ROC曲线分析发现NPAR对慢性心力衰竭急性发作患者30d死亡具有一定的预测价值(AUC=0.75,95%CI:0.63~0.88)。结论:高NPAR与慢性心力衰竭急性发作患者30d死亡风险增加相关。作为一项较易获得的实验室指标,在临床中NPAR可作为慢性心力衰竭急性发作患者的短期预后的预测因子.Objective:To explore the correlation between neutrophil percentage-to-albumin ratio(NPAR)and 30-day mortality in patients with acute decompensated heart failure,and to explore the prognostic value of NPAR.Methods:This study was a retrospective study.A total of 222 consecutive hospitalized patients with acute attack of chronic heart failure from January 2019 to December 2021 in First affiliated hospital of He Nan university of science and technology hospital were included.The patients were divided into the low NPAR group(NPAR<1.78)and the high NPAR group(NPAR≥1.78)according to the median NPAR(1.78).The clinical data of two groups were compared,and follow-up data were collected.Multivariate Logistic regression model was used to analyze the correlation between NPAR and 30-day mortality.Receiver operating characteristic(ROC)curve analysis and area under curve(AUC)were used to evaluate the predictive power of NPAR for 30-day mortality.Results:Patients in the high NPAR group were older,had a higher heart rate,had a higher proportion of women,had a higher proportion of type 2 diabetes,had a higher proportion of New York Heart Association Class IV cardiac function,and had higher levels of white blood cell count,neutrophil count,neutrophil proportion,fasting blood-glucose,serum creatinine,brain natriuretic peptide,and hypersensitive C-reactive protein.Multivariate regression analysis showed that high NPAR was independently and positively associated with an increased risk of 30-day mortality in patients with acute decompensated heart failure(OR=2.41,95%CI:1.07-8.43).ROC curve analysis showed that NPAR had a certain predictive value for 30-day mortality in patients with acute decompensated heart failure AUC=0.75,95%CI:0.63-0.88.Conclusions:High NPAR was associated with an increased risk of 30-day mortality in patients with acute decompensated heart failure.As a readily available laboratory measure,NPAR can be used clinically as a predictor of short-term outcome in patients with acute decompensated heart failure.

关 键 词：中性粒细胞百分比与白蛋白比值 心力衰竭 30天死亡 

分 类 号：R54[医药卫生—心血管疾病]