Objective To study the predictive value of platelet to lymphocyte ratio (PLR) for adverse cardiovascular and cerebrovascular events in severe heart failure. Methods 198 patients with severe heart failure admitted to cardiac medicine department of Affiliated Hospital of Henan Medical College from February 2014 to May 2018 were selected as research objects. The patients were divided into observation group (72 cases, adverse cardiovascular and cerebrovascular events occurred) and control group (126 cases, no adverse cardiovascular and cerebrovascular events occurred) according to whether adverse cardiovascular and cerebrovascular events occurred or not. The medical data of two groups of patients were collected respectively, the relationship between the basic data, biochemical indexes, PLR level and adverse cardiovascular and cerebrovascular events was analyzed, and multivariate logistic regression analysis was performed. In addition, the receiver operating characteristic curve (ROC) was used to analyze the energy efficiency of each index in the diagnosis of adverse cardiovascular and cerebrovascular events in patients with severe heart failure. Results The systolic blood pressure of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). The level of TG, PLR in the observation group was higher than those in the control group, while the left ventricular ejection fraction was lower than that in the control group (P<0.05). Logistic regression analysis showed that systolic blood pressure, triglyceride (TG) and PLR was independent risk factor for adverse cardiovascular and cerebrovascular events in patients with severe heart failure (P<0.05). ROC curve analysis showed that the area under the curve, sensitivity and specificity of PLR in the diagnosis of adverse cardiovascular and cerebrovascular events in patients with severe heart failure were higher than those of systolic blood pressure and TG (all P<0.05). Conclusion The incidence of adverse cardiovascular and cerebrovascular events in patients with severe heart failure is closely related to high level of PLR. In clinical work, the change of PLR level can be monitored, which is helpful to predict the occurrence of adverse cardiovascular and cerebrovascular events in the early stage and provide effective indicators for the prognosis of patients with severe heart failure.%目的 研究血小板/淋巴细胞比值(PLR)对重症心力衰竭患者发生不良心脑血管事件的预测价值.方法 以2014年2月至2018年5月于河南医学高等专科学校附属医院心血管内科收治的重症心力衰竭患者198例为研究对象.根据患者是否发生不良心脑血管事件分为观察组(发生不良心脑血管事件,n=72)和对照组(未发生不良心脑血管事件,n=126).采集两组患者病历资料,Logisitic回归分析重症心力衰竭患者发生不良心脑血管事件的危险因素,予以受试者工作特征(ROC)曲线分析各项指标诊断重症心力衰竭不良心脑血管事件的能效.结果 观察组收缩压高于对照组,差异有统计学意义(P＜0.05).观察组TG、PLR水平高于对照组,而左室射血分数低于对照组,差异有统计学意义(P均＜0.05).Logisitic回归分析显示:收缩压、三酰甘油(TG)、PLR均是重症心力衰竭患者发生不良心脑血管事件的独立危险因素(P均＜0.05).ROC曲线分析显示:PLR诊断重症心力衰竭患者不良心脑血管事件的曲线下面积、敏感性、特异性均高于收缩压、TG(P均＜0.05).结论 重症心力衰竭患者发生不良心脑血管事件与高水平PLR密切相关,临床工作中可通过对患者PLR水平的变化情况进行监测,从而有利于早期预测不良心脑血管事件的发生,为重症心力衰竭患者预后评估提供有效指标.
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