OBJECTIVE: To explore the value of the combined determination of the neutrophil-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) in the early diagnosis and prognosis evaluation of DM complicated with heart failure (HF).
METHODS: We retrospectively analyzed clinical data on 65 patients with type 2 DM (T2DM) complicated with HF (research group, Res) and 60 concurrent patients with uncomplicated T2DM (control group, Con) diagnosed at Zhejiang Provincial People\'s Hospital between January 2019 and December 2021. The NLR and RDW values were determined and comparatively analyzed, and their levels in T2DM + HF patients with different cardiac function grades were recorded. The receiver operating characteristic (ROC) curves were plotted to determine the NLR and RDW values (alone and in combination) for the early diagnosis of HF. The correlation between NLR and RDW with the presence or absence of cardiac events was also investigated.
RESULTS: Higher NLR and RDW levels were identified in the Res vs the Con groups (P < 0.05). The NLR and RDW increased gradually and synchronously with the deterioration of cardiac function in the Res group, with marked differences in their levels among patients with grade II, III, and IV HF (P < 0.05). ROC curve analysis revealed that NLR combined with RDW detection had an area under the curve of 0.915, a sensitivity of 76.9%, and a specificity of 100% for the early diagnosis of HF. Furthermore, HF patients with cardiac events showed higher NLR and RDW values compared with HF patients without cardiac events.
CONCLUSIONS: NLR and RDW were useful laboratory indicators for the early diagnosis of DM complicated with HF, and their joint detection was beneficial for improving diagnostic efficiency. Additionally, NLR and RDW values were directly proportional to patient outcomes.
目的:探讨联合检测中性粒细胞/淋巴细胞比值(NLR)和红细胞分布宽度(RDW)在DM合并心力衰竭(HF)早期诊断及预后评估中的价值。
方法:回顾性分析65例2型糖尿病(T2DM)合并HF患者的临床资料(研究组,Res)和60例并发无并发症T2DM患者(对照组,Con)2019年1月至2021年12月在浙江省人民医院诊断。确定了NLR和RDW值,并进行了比较分析,并记录其在不同心功能分级的T2DM+HF患者中的水平。绘制接收器工作特性(ROC)曲线以确定NLR和RDW值(单独和组合),以用于HF的早期诊断。还研究了NLR和RDW与是否存在心脏事件之间的相关性。
结果:Res组与Con组相比,NLR和RDW水平较高(P<0.05)。Res组NLR和RDW随着心功能的恶化而逐渐同步增加,在II级患者中,他们的水平有明显差异,III,和IVHF(P<0.05)。ROC曲线分析显示,NLR联合RDW检测曲线下面积为0.915,灵敏度为76.9%,对HF的早期诊断有100%的特异性。此外,与无心脏事件的HF患者相比,有心脏事件的HF患者显示更高的NLR和RDW值。
结论:NLR和RDW是早期诊断DM合并HF的有用实验室指标,两者联合检测有利于提高诊断效率。此外,NLR和RDW值与患者预后成正比。