摘要
目的探索中性粒细胞/高密度脂蛋白胆固醇比值(NHR)对老年高血压合并急性左心力衰竭(心衰)患者30 d主要不良心血管事件(MACE)的预测价值。方法选择首都医科大学宣武医院急诊科收治的老年高血压合并急性左心衰患者162例,根据血清NHR三分位水平分为低水平组(NHR<3.73),中水平组(3.73≤NHR<5.86)和高水平组(NHR≥5.86),每组54例,30 d随访时,记录MACE,用Kaplan-Meier生存曲线分析,用多因素Cox回归分析,ROC曲线分析。结果30 d随访时,低水平组MACE发生率低于中水平组和高水平组(7.41%vs 12.96%和27.78%,P=0.012);Kaplan-Meier生存曲线示,高水平组MACE发生时间早,发生率最高(P_(log rank)=0.013)。多因素Cox回归分析示,NHR是患者30 d发生MACE的独立预测因素(OR=1.185,95%CI:1.044~1.344,P=0.008)。ROC曲线分析示,NHR有预测24、48和72 h心衰好转及30 d发生MACE的价值(P<0.05,P<0.01)。结论NHR对老年高血压合并急性左心衰患者病情转归及30 d发生MACE有一定的预测价值。
Objective To study the value of neutrophil to HDL-C ratio(NHR)for predicting the 30-day incidence of MACE in hypertensive patients with acute left HF.Methods One hundred and sixty-two≥60 years old hypertensive patients with acute left HF admitted to our hospital were divided into low NHR(<3.73)group(n=54),medium NHR(≥3.73,<5.86)group(n=54)and high NHR(≥5.86)group(n=54).The patients were followed up for 30 days,during which the incidence of MACE was recorded and analyzed by Kaplan-Meier survival curve analy-sis,multivariate Cox regression analysis,ROC curve analysis respectively.Results The incidence of MACE was significantly lower in low NHR group than in medium and high NHR groups dur-ing the 30-day follow-up period(7.41%vs 12.96%,27.78%,P=0.012).Kaplan-Meier survival curve analysis showed that the developing time of MACE was the earlest and the incidence of MACE was the highest in high NHR group(P_(log rank)=0.013).Multivariate Cox regression analy-sis displayed that NHR was an independent predictor of the 30-day incidence of MACE in hyper-tensive patients with acute left HF(OR=1.185,95%CI:1.044-1.344,P=0.008).ROC curve analysis revealed that NHR was useful in predicting improvement of HF at 24,48,and 72 h and incidence of MACE at 30-day in hypertensive patients with acute left HF(P<0.05,P<0.01).Conclusion NHR plays a certain role in improving the HF and reducing the 30-day incidence of MACE in hypertensive patients with acute left HF.
作者
何婧瑜
赵芯晨
翟文亮
华琦
王晶
He Jingyu;Zhao Xinchen;Zhai Wenliang;Hua Qi;Wang Jing(Emergency Department,Affiliated Xuanwu Hospital of Capital Medical University,National Clinical Research Center for Geriatric Diseases,Beijing 100053,China)
出处
《中华老年心脑血管病杂志》
北大核心
2022年第1期4-7,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
国家重点研发计划(2018YFC1312000)。
