NLR RDW及NT-proBNP对老年冠心病患者衰弱的诊断价值

目的 探讨中性粒细胞/淋巴细胞比值(NLR)、红细胞分布宽度(RDW)及氨基末端脑钠肽前体(NT-proBNP)对老年冠心病患者衰弱的诊断价值.方法 选择2017年7月至2019年12月在中国科技大学附属第一医院老年医学科收治的年龄≥60岁的冠心病患者265例,根据Fried衰弱表型量表,分为衰弱组(n=141)与非衰弱组(n=124).收集两组患者合并慢性疾病及入院时血清学相关指标情况,并进行组间比较,采用受试者工作特征(ROC)曲线分析其诊断价值.结果 衰弱组患者中性粒细胞计数为(5.55±1.11)×109/L、NLR为4.99(4.32,5.63)、RDW为(15.29±1.17)％、NT-proBNP为2220(988.50,3420.00)]pg/mL,均高于非衰弱组;淋巴细胞计数为(1.13±0.28)×109/L、血红蛋白表达水平为(127.81±11.28)g/L,均低于非衰弱组,差异均有统计学意义(P<0.05).logistic回归分析结果显示,NLR、RDW和NT-proBNP是老年冠心病患者发生衰弱的危险因素(P<0.05),NLR诊断老年冠心病患者衰弱程度的ROC曲线下面积(AUC)为0.932,RDW的AUC为0.905,NT-proBNP的AUC为0.843.结论 血清学指标NLR、RDW及NT-proBNP升高是老年冠心病患者发生衰弱的危险因素,有助于早期评估老年冠心病患者衰弱情况,并及早给予干预.

Diagnostic value of NLR RDW and NT-proBNP in frailty elderly patients with coronary heart disease

Objective To explore the diagnostic yalue of neutrophil-lymphocyte ratio(NLR),red blood cell distribution width(RDW) and N-terminal pro-brain natriuretic peptide(NT-proBNP) in the diagnosis of frailty in elderly patients with coronary heart disease. Methods Form July 2017 to December 2019,265 patients aged 60 years and over with coronary heart disease were continuously recruited from the Department of Geriatric Cardiology of the First Affiliated Hospital of USTC. Participants were assigned into frailty group(141 cases) and non-frailty group(124 cases) according to the Fried Frailty Criteria.Then the differences in serum indexes and incidence of chronic complications were analyzed between the two groups.The ROC curves of frailty related serum indexes were drawn and the optimal cut-off points were determined. Results In comparison of the frailty with the non-frailty group,the higher serum levels were found in neutrophil(5.24±1.85)×10⁹/L,in NLR 4.99(4.32,5.63),in RDW (15.29±1.17)%,and in NT-proBNP 2 220(988.50,3 420.00)pg/mL(all P<0.05),while the lower serum levels were found in lymphocyte(1.13±0.28) and in hemoglobin(127.81±11.28)(all P<0.05).Logistic regression analysis showed that NLR,RDW, NT-proBNP were the risk factors of frailty in elderly patients with coronary heart disease.The AUC values of NLR diagnosed in elderly patients with CHD were 0.932, the AUC of RDW was 0.905, and the AUC of NT-proBNP was 0.843.Conclusions The plasma levels of NLR,RDW and NT-proBNP value are risk factors in elderly CHD patients with frailty. This can draw attention to patients and give appropriate interventions as early as possible.