淋巴细胞百分比与老年慢性心力衰竭发病的相关性

Correlation between lymphocyte percentage and onset of chronic heart failure in the elderly

关键词:  淋巴细胞百分比  心力衰竭  老年人

Key words:  lymphocyte percentage  heart failure  elderly

摘要:

目的 分析淋巴细胞百分比(lymphocyte percentage, LYM%)与老年慢性心力衰竭(heart failure, HF)患者发病之间的相关性。 方法 纳入2020年10月—2021年10月在同济大学附属同济医院心脏康复科住院治疗的老年HF患者79例(HF组)及同期无心力衰竭患者130例(对照)组。通过医院信息数据库电子病历系统回顾患者临床资料，包括人口统计学数据、诊断信息、住院24 h内的化验室数据等。应用Spearman相关性分析评估各个危险因素与老年HF之间的相关性，绘制ROC曲线分析评估LYM%对老年HF的预测价值，根据ROC最佳截断值将患者分为高LYM%组(LYM%≥20.75%)和低LYM%组(LYM%＜20.75%)后分别进行单因素及多因素Logistic回归分析，明确LYM%是否为老年HF的危险因素。 结果 Spearman相关性分析显示，LYM%与HF呈负相关(r=-0.409,P＜0.001)；年龄、冠心病、心房颤动、感染及中性粒细胞百分比(r=0.425，0.190，0.368，0.344，0.377，P＜0.05)与HF呈正相关。ROC曲线分析显示，ROC曲线下面积为0.742(95%CI： 0.671~0.813)，LYM%的最佳截断值为20.75%，相应诊断灵敏度为83.8%，特异度为59.5%。多因素Logistic回归分析显示，LYM%与老年HF发病存在统计学意义(OR=6.048，95%CI: 1.83~19.991，P=0.003)。 结论 LYM%是老年HF患者发病的独立预测因素，具有显著的诊断价值。其检测简便、经济高效，适合作为老年HF的早期识别和诊断工具。

Abstract:

Objective To analyze the correlation between lymphocyte percentage(LYM%) and the onset of heart failure(HF) in elderly patients. Methods A cross-sectional study was conducted on 79 elderly HF patients admitted to the Cardiac Rehabilitation Department of Tongji Hospital Affiliated with Tongji University between October 2020 and October 2021, and 130 control patients without HF during the same period. Clinical data of patients were reviewed through the hospital information database electronic medical record system, including demographic data, diagnostic information, and laboratory data within 24 hours of admission. Spearman correlation analysis was used to evaluate the correlation between various risk factors and elderly HF. Receiver operating characteristic(ROC) curve analysis was performed to assess the predictive value of LYM% for elderly HF. The patients were divided into high LYM% group(LYM%≥20.75%) and low LYM% group(LYM%＜20.75%) according to the optimal cutoff value of ROC, and univariate and multivariate Logistic regression analyses were performed to clarify whether LYM% was a risk factor for elderly HF. Results Spearman correlation analysis showed a significant negative correlation between LYM% and HF(r=-0.409, P＜0.001); age, coronary artery disease, atrial fibrillation, infection, and neutrophil percentage were significantly positively correlated with HF(r=0.425, 0.190, 0.368, 0.344, 0.377, all P＜0.05). ROC curve analysis showed an area under the ROC curve of 0.742, 95%CI: 0.671-0.813, with the optimal cutoff value of LYM% being 20.75%, corresponding to a diagnostic sensitivity of 83.8% and specificity of 59.5%. Multivariate Logistic regression analysis showed a statistically significant association between LYM% and the onset of elderly HF(OR=6.048, 95%CI: 1.83-19.991, P=0.003). Conclusion LYM% is an independent predictive factor for the onset of elderly HF and has significant diagnostic value. The simple and cost-effective detection of LYM% makes it suitable as an early identification and diagnostic tool for elderly HF.