炎症和营养相关指标与心力衰竭患者的死亡率之间的关联:一个队列研究
Songtao Liu1, Ting Fu2, Tianhua Deng1
1Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China.
Frontiers in nutrition
|November 13, 2025
概括
炎症和营养不良指标预测心力衰竭死亡率. 红细胞分布宽度与白蛋白比率 (RAR) 对于短期风险是最好的,而晚期肺癌炎症指数 (ALI) 预测心力衰竭患者的长期结果.
科学领域:
- 心脏病学 心脏病学
- 生物标志物 生物标志物
- 公共卫生 公共卫生
背景情况:
- 炎症和营养不良显著影响心力衰竭 (HF) 的进展和患者的结果.
- 确定可靠的预后指标对于管理HF患者至关重要.
研究的目的:
- 评估各种炎症和营养相关指标的预后价值,以预测心力衰竭患者的死亡率.
- 为了比较这些指标对短期和长期死亡率的预测性表现.
主要方法:
- 从1999-2018年国家健康和营养检查调查 (NHANES) 数据集中对1500名心力衰竭患者的回顾性分析.
- 评估多个与炎症和营养相关的指数,包括晚期肺癌炎症指数 (ALI) 和红细胞分布宽度与白蛋白比率 (RAR).
- 统计分析包括卡普兰-梅尔曲线,考克斯回归,限制立方线,时间依赖ROC分析和随机生存森林 (RSF) 建模.
主要成果:
- 单细胞与白蛋白比率 (MAR),中性粒细胞与白蛋白比率 (NAR),红细胞分布宽度与白蛋白比率 (RAR) 和控制营养状况 (CONUT) 评分的升高与死亡率的增加有关.
- 升高的ALI,预后营养指数 (PNI),老年营养风险指数 (GNRI) 和血红蛋白-白蛋白-淋巴细胞-血小板 (HALP) 分数与死亡率降低有关.
- RAR显示出最强的预测能力,对1年全因和心血管死亡率 (AUCs ≈0.77-0.79) 的预测能力.
- ALI显示了3,5年和10年死亡率的最佳预测性能 (AUCs ≈0.68-0.70).
- 随机生存森林分析确定ALI是死亡风险的主要预测因素.
结论:
- 红细胞分布宽度与白蛋白比率 (RAR) 为心力衰竭患者的短期死亡风险提供了优异的预测价值.
- 晚期肺癌炎症指数 (ALI) 显示了心力衰竭患者长期死亡风险的优异预测价值.
- 这些基于炎症和营养的指数是心力衰竭管理中风险分层的有价值工具.
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