单核细胞增多及其衍生指标与急性心肌梗死后急性心力衰竭的临床严重程度相关。
Increased monocytes and their derived indicators are associated with clinical severity of acute heart failure following acute myocardial infarction.
作者信息
Xiong Xinlin, An Minsheng, Yuan Li, Long Xiaobin, Huang Shen
机构信息
Department of Cardiology, Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
出版信息
Front Cardiovasc Med. 2025 Apr 10;12:1566635. doi: 10.3389/fcvm.2025.1566635. eCollection 2025.
OBJECTIVE
Monocytes play a significant role in the pathophysiology of acute myocardial infarction (AMI). The relationship between monocytes, their derived indicators, and the severity of acute heart failure following AMI remains unclear. Therefore, this study aims to investigate the association of monocytes and their derived indicators with clinical severity of acute heart failure in the patients with AMI.
METHODS
In total of 173 patients with AMI were enrolled in this retrospective study. The demographic data and relevant medical histories were obtained. Monocytes and lipid levels were measured. All patients were divided into two groups based on killip classification. Killip class III-IV was defined as acute severe heart failure, while killip class I-II was defined as acute non-severe heart failure.
RESULTS
Monocyte count, monocyte-to-white blood cell ratio, and monocyte-to-lymphocyte ratio were significantly higher in patients with acute severe heart failure compared to those with acute non-severe heart failure ( < 0.05). Multivariate logistic regression analysis showed that monocyte count, monocyte-to-white blood cell ratio, and monocyte-to-lymphocyte ratio were independently associated with acute severe heart failure ( < 0.05). Moreover, monocyte count, monocyte-to-white blood cell ratio, and monocyte-to-lymphocyte ratio were linked to NT-proBNP concentrations ( < 0.05). Receiver-operating characteristic curve analysis showed that monocyte count, monocyte-to-white blood cell ratio, and monocyte-to-lymphocyte ratio could identify acute severe heart failure in patients following AMI to some extent ( < 0.05).
CONCLUSION
The elevation of monocyte count, monocyte-to-white blood cell ratio, and monocyte-to-lymphocyte ratio correlated with clinical severity of acute heart failure following AMI, and offered potential discriminating value for cardiogenic pulmonary edema and shock following AMI.
目的
单核细胞在急性心肌梗死（AMI）的病理生理学中起重要作用。单核细胞及其衍生指标与AMI后急性心力衰竭严重程度之间的关系仍不明确。因此，本研究旨在探讨单核细胞及其衍生指标与AMI患者急性心力衰竭临床严重程度的相关性。
方法
本回顾性研究共纳入173例AMI患者。获取人口统计学数据和相关病史。检测单核细胞和血脂水平。所有患者根据Killip分级分为两组。Killip III-IV级定义为急性严重心力衰竭，而Killip I-II级定义为急性非严重心力衰竭。
结果
与急性非严重心力衰竭患者相比，急性严重心力衰竭患者的单核细胞计数、单核细胞与白细胞比值以及单核细胞与淋巴细胞比值显著更高（<0.05）。多因素逻辑回归分析显示，单核细胞计数、单核细胞与白细胞比值以及单核细胞与淋巴细胞比值与急性严重心力衰竭独立相关（<0.05）。此外，单核细胞计数、单核细胞与白细胞比值以及单核细胞与淋巴细胞比值与NT-proBNP浓度相关（<0.05）。受试者工作特征曲线分析表明，单核细胞计数、单核细胞与白细胞比值以及单核细胞与淋巴细胞比值在一定程度上可识别AMI后患者的急性严重心力衰竭（<0.05）。
结论
单核细胞计数、单核细胞与白细胞比值以及单核细胞与淋巴细胞比值的升高与AMI后急性心力衰竭的临床严重程度相关，并为AMI后的心源性肺水肿和休克提供了潜在的鉴别价值。
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