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目的探讨血小板与淋巴细胞比值(PLR)、红细胞分布宽度(RDW)与慢性心力衰竭(CHF)的关系。方法选取CHF患者75例,按NYHA心功能分级标准将患者分级,同时选择76例健康体检者做对照组,记录年龄、性别、血肌酐(Scr)、尿素(BUN)、尿酸(UA)、低密度脂蛋白胆固醇(LDL-C)、白细胞计数(WBC)、血小板与淋巴细胞比值(PLR)、红细胞计数(RBC)、血小板计数(PLT)、红细胞分布宽度(RDW)等指标,同时分析CHF与上述指标的关系。结果高血压、糖尿病患病率,生化指标中CR、BUN、UA、LDL-C以及血液学指标中RBC、Hb、PLR、RDW在2组间差异有统计学意义(P<0.05)。经Logistic回归分析显示,高血压、LDL-C、尿酸、PLR、RDW均是心衰的独立危险因素,并且PLR、RDW随着心功能分级的增加而升高。PLR及RDW对心衰诊断的最佳截断值分别为128.30及13.15%,PLR及RDW增高组心衰的发生率远高于正常组,差异有统计学意义(P<0.01)。结论 PLR、RDW是CHF的独立危险因素,且与心功能等级呈正相关。
Objective To investigate the relationship between platelet to lymphocyte ratio (PLR), distribution width of red blood cells (RDW) and chronic heart failure (CHF). Methods Seventy-five patients with CHF were enrolled in this study. The patients were graded according to the New York Heart Association (NYHA) classification criteria. Sixty-six healthy subjects were selected as the control group. Age, sex, serum creatinine (Scr), urea (BUN), uric acid LDL-C, WBC, PLR, RBC, PLT, RDW and other indexes of CHF and The above indicators of the relationship. Results The prevalence of hypertension, diabetes mellitus, CR, BUN, UA, LDL-C and hematological indexes of RBC, Hb, PLR and RDW were significantly different between the two groups (P <0.05). Logistic regression analysis showed that hypertension, LDL-C, uric acid, PLR and RDW were all independent risk factors of heart failure, and PLR and RDW increased with the increase of heart function. The best cut-off value of PLR and RDW for heart failure diagnosis was 128.30 and 13.15%, respectively. The incidence of heart failure in PLR and RDW group was much higher than that in normal group (P <0.01). Conclusions PLR and RDW are independent risk factors of CHF and positively correlated with the level of cardiac function.