山东医药

目的 探讨炎症负担指数（IBI）对急性心力衰竭患者疾病转归的预测价值。方法 选择急性心力衰竭患者120例，入院后采集外周静脉血测算IBI。收集患者临床资料，采用多因素Logistic回归分析影响急性心力衰竭患者预后不良的影响因素，绘制受试者工作特征（ROC）曲线分析IBI对急性心力衰竭患者预后不良的预测价值。结果 120例患者中出院后1年内预后不良26例、预后良好94例。预后不良者的IBI高于预后良好者（P<0.05）。单因素分析结果，预后不良者NYHA分级、外周血中白蛋白、N末端B型脑钠肽前体（NT-proBNP）、C反应蛋白、中性粒细胞计数均高于预后良好者，左心室射血分数（LVEF）、淋巴细胞计数水平均低于预后良好者（P均<0.05）；多因素分析结果，NYHA分级Ⅱ～Ⅲ级（OR=1.747）及血清NT-proBNP>3 354.25 pg/mL(OR=2.678)、LVEF≤44.25%(OR=3.459)、IBI>27.54(OR=4.367)均为急性心力衰竭患者预后不良的危险因素（P均<0.05）。ROC曲线分析显示，IBI预测急性心力衰竭患者预后不良的曲线下面积为0.845(95%CI:0.795～0.896)。结论 急性心力衰竭预后不良患者IBI异常升高；IBI对急性心力衰竭患者预后不良具有一定预测效能。

Objective To explore the predictive value of the inflammatory burden index(IBI) for the prognosis of patients with acute heart failure. Methods A total of 120 patients with acute heart failure were selected. Peripheral venous blood was collected from the patients after admission to calculate the IBI. The clinical data of the patients were collected. Multivariate Logistic regression analysis was used to analyze the influencing factors for the poor prognosis of patients with acute heart failure. The receiver operating characteristic(ROC) curve was drawn to analyze the predictive value of IBI for the poor prognosis of patients with acute heart failure. Results Among the 120 patients, 26 had a poor prognosis within one year after discharge and 94 had a good prognosis. The IBI of patients with poor prognosis was higher than that of patients with good prognosis(P<0. 05). The results of univariate analysis showed that the NYHA classification, albumin, N-terminal pro-B-type natriuretic peptide(NT-proBNP), C-reactive protein, and neutrophil count in the peripheral blood of patients with poor prognosis were higher than those of patients with good prognosis, while the left ventricular ejection fraction(LVEF) and lymphocyte count were lower(all P<0. 05). The results of multivariate analysis showed that NYHA classification Ⅱ-Ⅲ （OR=1. 747）, serum NT-proBNP > 3354. 25 pg/mL(OR=2. 678), LVEF ≤ 44. 25%(OR=3. 459), and IBI > 27. 54(OR=4. 367) were all risk factors for the poor prognosis of patients with acute heart failure(all P<0. 05). The ROC curve analysis showed that the area under the curve(AUC) of IBI in predicting the poor prognosis of patients with acute heart failure was 0. 845(95% CI: 0. 795-0. 896). Conclusion IBI is abnormally elevated in acute heart failure patients with poor prognosis, and IBI has a certain predictive value for the poor prognosis in patients with acute heart failure.