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血小板与淋巴细胞比值对急性心力衰竭患者预后的作用:一项队列研究。

The prognostic role of platelet-to-lymphocyte ratio in patients with acute heart failure: A cohort study.

机构信息

Department of Surgery, Shandong Provincial Taishan Hospital, Taian, 271000, Shandong, China.

School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, 271016, Shandong, China.

出版信息

Sci Rep. 2019 Jul 23;9(1):10639. doi: 10.1038/s41598-019-47143-2.

Abstract

Identification of rapid, inexpensive, and reliable prognostic factors can improve survival estimation and guide healthcare in patients with acute heart failure (AHF). In this study, we aimed to determine the prognostic value of the platelet-to-lymphocyte ratio (PLR) in patients with AHF. A total of 443 patients from two hospitals met the inclusion criteria from January 2010 to December 2017. Univariate and multivariate Cox analyses were performed to determine the association of PLR with survival. All-cause mortality was analysed using the Kaplan-Meier method. The 6-month survival rate for patients according to PLR quartiles (<110.63, 110.63-139.23, 139.23-177.17, and >177.17) were 90.09%, 76.79%, 50.07%, and 37.27%, respectively (p < 0.001). Univariate analysis identified high PLR (>110.63), old age (≥73 years), smoking habit, low estimated glomerular filtration rate (<57), and high platelet count (≥198 × 10/l) as poor prognostic factors for survival. In the multivariate analysis, after adjusting for confounding factors, the third (hazard ratio [HR] = 3.118, 95% confidence interval [CI] = 1.668-5.386, p < 0.001) and fourth (HR = 2.437, 95% CI = 1.302-3.653, p < 0.001) quartiles of PLR were identified as independent prognostic factors in patients with AHF. A higher PLR was associated with poor clinical outcomes in patients with AHF and might be a novel marker in AHF management.

摘要

识别快速、廉价和可靠的预后因素可以改善急性心力衰竭(AHF)患者的生存估计,并指导医疗保健。在这项研究中,我们旨在确定血小板与淋巴细胞比值(PLR)在 AHF 患者中的预后价值。共有 443 名来自两家医院的患者符合纳入标准,纳入时间为 2010 年 1 月至 2017 年 12 月。进行单变量和多变量 Cox 分析以确定 PLR 与生存的关联。使用 Kaplan-Meier 方法分析全因死亡率。根据 PLR 四分位数(<110.63、110.63-139.23、139.23-177.17 和>177.17),患者的 6 个月生存率分别为 90.09%、76.79%、50.07%和 37.27%(p<0.001)。单变量分析确定高 PLR(>110.63)、年龄较大(≥73 岁)、吸烟习惯、肾小球滤过率低(<57)和血小板计数高(≥198×10/l)为生存的不良预后因素。在多变量分析中,调整混杂因素后,第三个(危险比 [HR]=3.118,95%置信区间 [CI]=1.668-5.386,p<0.001)和第四个(HR=2.437,95% CI=1.302-3.653,p<0.001)PLR 四分位数被确定为 AHF 患者的独立预后因素。较高的 PLR与 AHF 患者的不良临床结局相关,可能是 AHF 管理中的一个新标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83b1/6650439/6e4f2c22b98f/41598_2019_47143_Fig1_HTML.jpg

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