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中性粒细胞与淋巴细胞比值及红细胞分布宽度在糖尿病合并心力衰竭中的应用

Application of neutrophil-lymphocyte ratio and red blood cell distribution width in diabetes mellitus complicated with heart failure.

作者信息

Pang Jie, Qian Lin-Yan, Lv Ping, Che Xiao-Ru

机构信息

Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People's Hospital (The Affiliated People's Hospital), Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China.

出版信息

World J Diabetes. 2024 Jun 15;15(6):1226-1233. doi: 10.4239/wjd.v15.i6.1226.

Abstract

BACKGROUND

Accumulating clinical evidence has shown that diabetes mellitus (DM) is a serious risk factor for cardiovascular disorders and an important factor for adverse cardiovascular events.

AIM

To explore the value of the combined determination of the neutrophil-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) in the early diagnosis and prognosis evaluation of DM complicated with heart failure (HF).

METHODS

We retrospectively analyzed clinical data on 65 patients with type 2 DM (T2DM) complicated with HF (research group, Res) and 60 concurrent patients with uncomplicated T2DM (control group, Con) diagnosed at Zhejiang Provincial People's Hospital between January 2019 and December 2021. The NLR and RDW values were determined and comparatively analyzed, and their levels in T2DM + HF patients with different cardiac function grades were recorded. The receiver operating characteristic (ROC) curves were plotted to determine the NLR and RDW values (alone and in combination) for the early diagnosis of HF. The correlation between NLR and RDW with the presence or absence of cardiac events was also investigated.

RESULTS

Higher NLR and RDW levels were identified in the Res the Con groups ( < 0.05). The NLR and RDW increased gradually and synchronously with the deterioration of cardiac function in the Res group, with marked differences in their levels among patients with grade II, III, and IV HF ( < 0.05). ROC curve analysis revealed that NLR combined with RDW detection had an area under the curve of 0.915, a sensitivity of 76.9%, and a specificity of 100% for the early diagnosis of HF. Furthermore, HF patients with cardiac events showed higher NLR and RDW values compared with HF patients without cardiac events.

CONCLUSION

NLR and RDW were useful laboratory indicators for the early diagnosis of DM complicated with HF, and their joint detection was beneficial for improving diagnostic efficiency. Additionally, NLR and RDW values were directly proportional to patient outcomes.

摘要

背景

越来越多的临床证据表明,糖尿病(DM)是心血管疾病的严重危险因素,也是不良心血管事件的重要因素。

目的

探讨中性粒细胞与淋巴细胞比值(NLR)和红细胞分布宽度(RDW)联合检测在糖尿病合并心力衰竭(HF)早期诊断及预后评估中的价值。

方法

回顾性分析2019年1月至2021年12月在浙江省人民医院确诊的65例2型糖尿病(T2DM)合并HF患者(研究组,Res)和60例单纯T2DM患者(对照组,Con)的临床资料。测定并比较分析NLR和RDW值,记录其在不同心功能分级的T2DM + HF患者中的水平。绘制受试者工作特征(ROC)曲线,确定NLR和RDW值(单独及联合)用于HF早期诊断的情况。还研究了NLR和RDW与心脏事件发生与否的相关性。

结果

Res组的NLR和RDW水平高于Con组(P < 0.05)。Res组中,NLR和RDW随心脏功能恶化而逐渐同步升高,在II级、III级和IV级HF患者中其水平有显著差异(P < 0.05)。ROC曲线分析显示,NLR联合RDW检测对HF早期诊断的曲线下面积为0.915,灵敏度为76.9%,特异性为100%。此外,发生心脏事件的HF患者的NLR和RDW值高于未发生心脏事件的HF患者。

结论

NLR和RDW是糖尿病合并HF早期诊断的有用实验室指标,联合检测有助于提高诊断效率。此外,NLR和RDW值与患者预后成正比。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a30f/11229955/cddc1b46e449/WJD-15-1226-g001.jpg

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