合并T2DM的老年HFpEF患者SIRI特征与心力衰竭严重程度的相关性分析  

An Analysis of the Correlation Between SIRI Characteristics and the Severity of Heart Failure in Elderly HFpEF Patients with T2DM

作　　者：赵佳敏 刘永铭[2] ZHAO Jiamin;LIU Yongming(The First Clinical Medical College of Lanzhou University,Lanzhou 730030,China;Department of Geriatrics,The First Hospital of Lanzhou University,Lanzhou 730030,China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730030 [2]兰州大学第一医院老年病一科,甘肃兰州730030

出　　处：《标记免疫分析与临床》2025年第2期297-302,308,共7页Labeled Immunoassays and Clinical Medicine

基　　金：甘肃省科技计划项目(编号:20YF8FA079)。

摘　　要：目的探究合并2型糖尿病(T2DM)的老年射血分数保留心力衰竭(HFpEF)患者系统炎症反应指数(SIRI)特征与心力衰竭严重程度的相关性。方法以2016年1月至2024年4月就诊于兰州大学第一医院的300例合并T2DM的老年HFpEF患者作为研究对象,根据患者纽约心脏病协会(NYHA)心功能分级划分为轻度心力衰竭组(n=220)和中重度心力衰竭组(n=80)。对比两组患者间一般临床资料、炎症相关指标[单核细胞/高密度脂蛋白比值(MHR)、中性粒细胞/淋巴细胞比值(NLR)、SIRI]、心肌损伤标志物[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、N末端B型钠尿肽前体(NT-proBNP)]的差异,通过Spearman相关性检验、Logistic回归分析评价各指标与合并T2DM的老年HFpEF患者心力衰竭严重程度的相关性。结果中重度心力衰竭组患者中合并高血压患者比例、平均体质指数、合并吸烟史患者比例均显著高于轻度心力衰竭组患者(P<0.05);中重度心力衰竭组患者平均MHR、NLR、SIRI、CK、CK-MB、NT-proBNP均显著高于轻度心力衰竭组患者(P<0.05);Spearman相关性分析表明合并高血压、合并吸烟史、体质指数、MHR、NLR、SIRI、CK、CK-MB、NT-proBNP均与合并T2DM的老年HFpEF患者心衰严重程度呈显著正相关(P<0.05);单因素及多因素Logistic回归分析发现MHR、NLR、SIRI均是合并T2DM的老年HFpEF患者中重度心衰的重要危险因素(P<0.05)。结论合并T2DM的老年HFpEF患者MHR、NLR、SIRI水平较高均与严重心力衰竭密切相关,针对此类高危患者在临床治疗过程中应给予更多关注。Objective To evaluate the relationship between the systemic inflammation response index(SIRI)features and the degree of heart failure in aged individuals with heart failure but preserved ejection fraction(HFpEF)who are also complicated with type 2 diabetes mellitus(T2DM).Methods A total of 300 elderly patients with HFpEF and T2DM who visited our hospital between January,2016 and April,2024 were recruited for this study.These patients were categorized into a group with mild heart failure(n=220)and a group with moderate to severe heart failure(n=80)based on the New York Heart Association(NYHA)functional classification standard.A comparative analysis was conducted between the two groups in terms of general clinical characteristics,inflammation-related parameters[including monocyte/high-density lipoprotein ratio(MHR),neutrophil/lymphocyte ratio(NLR),and systemic immune-inflammation index(SIRI)],and myocardial injury markers[such as creatine kinase(CK),creatine kinase-MB isoenzyme(CK-MB),and N-terminal pro-B-type natriuretic peptide(NT-proBNP)].The association between these markers and the severity of heart failure in elderly HFpEF patients with T2DM was then assessed using Spearman correlation analysis and logistic regression modeling.Results In the group of elderly HFpEF patients with T2DM,there was a higher prevalence of hypertension,an elevated average body mass index,and a greater percentage of patients with a history of smoking in the moderate to severe heart failure category compared to the mild heart failure category(P<0.05).The moderate to severe heart failure group exhibited notably higher average levels of MHR,NLR,SIRI,CK,CK-MB,and NT-proBNP than the mild heart failure group(P<0.05).Spearman correlation analysis indicated that hypertension,smoking history,body mass index,as well as MHR,NLR,SIRI,CK,CK-MB,and NT-proBNP all had significant positive correlations with the severity of heart failure in elderly HFpEF patients with T2DM(P<0.05).Both univariate and multivariate logistic regression analyses revealed t

关 键 词：2型糖尿病 射血分数保留心力衰竭 系统炎症反应指数 

分 类 号：R587.1[医药卫生—内分泌]