外周血SII、NLR、PLR与老年慢性肺源性心脏病患者病情程度及预后的关系  

Association of peripheral blood SII,NLR,PLR with disease severity and prognosis in elderly patients with chronic pulmonary heart disease

作　　者：江美兵 付海琴 南阳光 周俊 JIANG Mei-bing;FU Hai-qin;NAN Yang-guang;ZHOU Jun(Department of Respiratory and Critical Care Medicine,Xuancheng Central Hospital,Xuancheng,Anhui,242000,China)

机构地区：[1]宣城市中心医院呼吸与危重症医学科,安徽宣城242000

出　　处：《心血管康复医学杂志》2025年第2期156-161,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:分析老年慢性肺源性心脏病(CPHD)患者外周血系统免疫炎症指数(SII)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)与病情程度及预后的关系。方法:纳入2021年9月-2023年1月宣城市中心医院收治的180例老年CPHD患者(病例组),选择同期于本院进行体检的健康志愿者作为对照组(n=50),根据28d预后情况将病例组分为死亡组(n=45)和生存组(n=135)。比较各组SII、NLR、PLR;Spearman法分析CPHD患者外周血SII、NLR、PLR与心功能分级及预后的相关性;多因素Logistic回归分析影响老年CPHD患者死亡的危险因素;受试者工作特征(ROC)曲线分析SII、NLR、PLR对老年CPHD患者死亡的预测价值。结果:与对照组比较,病例组外周血SII、NLR、PLR水平显著升高(P均<0.001)。与纽约心脏病协会(NYHA)心功能分级Ⅱ级组、Ⅲ级组比较,Ⅳ级组外周血SII[(1759.87±179.43)比(1148.33±121.57)比(1392.44±146.36)]、NLR[(8.65±0.89)比(7.14±0.75)比(7.76±0.81)]、PLR[(152.45±16.79)比(125.29±13.46)比(138.77±13.58)]均显著升高;且Ⅲ级组外周血SII、NLR、PLR均显著高于Ⅱ级组(P均<0.001)。与生存组比较,死亡组的外周血SII[(1723.86±189.65)比(1296.81±142.33)]、NLR[(8.24±0.89)比(7.63±0.78)]、PLR[(148.75±15.26)比(134.41±14.58)]显著升高(P均<0.001)。Spearman相关分析显示,外周血SII、NLR、PLR水平与患者病情严重程度(r=0.336~0.432,P<0.05或<0.01)及预后不良呈正相关(r=0.319~0.504,P<0.05或<0.01)。多因素Logistic回归分析结果显示,外周血SII、NLR、PLR、吸烟史是老年CPHD患者死亡的独立危险因素(OR=1.024~9.514,P<0.05或<0.01);ROC曲线显示,SII、NLR、PLR联合预测老年CPHD患者死亡的曲线下面积(AUC)为0.979(95%CI 0.946~0.995),显著高于均高于各单独检测[SII:0.847(95%CI 0.786~0.896),NLR:0.832(95%CI 0.769~0.883),PLR:0.881(95%CI 0.825~0.925),Z=3.988,4.386,4.217,P均<0.01]。列线图校准曲线、决策曲线表明该模型具有良好的�Objective:To analyze the association of peripheral blood systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)with disease severity and prognosis in elderly patients with chronic pulmonary heart disease(CPHD).Methods:A total of 180 elderly CPHD patients admitted in Xuancheng Central Hospital between September 2021 and January 2023 were enrolled as case group.Healthy volunteers who simultaneously underwent physical examinations in our hospital were selected as control group(n=50).According to the 28d prognosis,the case group was divided into death group(n=45)and survival group(n=135).Levels of peripheral blood SII,NLR and PLR were compared among above-mentioned groups;Spearman correlation analysis was used to analyze the association of above indexes with cardiac function class and prognosis in these patients.Multivariate Logistic regression analysis was used to analyze risk factors for death in these patients.The predictive value of SII,NLR,and PLR for death in elderly CPHD patients was analyzed using receiver operating characteristic(ROC)curve.Results:Compared with those in control group,those in the case group had significant higher levels of peripheral blood SII,NLR and PLR(P<0.001 all).Compared with NYHA class II group and class III group,those in class IV group had significant higher levels of peripheral blood SII[(1759.87±179.43)vs.(1148.33±121.57)vs.(1392.44±146.36)],NLR[(8.65±0.89)vs.(7.14±0.75)vs.(7.76±0.81)],PLR[(152.45±16.79)vs.(125.29±13.46)vs.(138.77±13.58)];and levels of peripheral blood SII,NLR,PLR in class III group were significantly higher than those of class II group(P<0.001 all).Compared with patients in survival group,those in death group had significant higher levels of peripheral blood SII[(1723.86±189.65)vs.(1296.81±142.33)],NLR[(8.24±0.89)vs.(7.63±0.78)],PLR[(148.75±15.26)vs.(134.41±14.58)](P<0.001 all).Spearman correlation analysis indicated that the levels of peripheral blood SII,NLR and PLR were significant positivel

关 键 词：肺心病 炎症 中性白细胞 淋巴细胞 血小板 

分 类 号：R541.5[医药卫生—心血管疾病]