Clinical Value Of Blood Routine Related Parameters In The Treatment Of Chronic Heart Failure

Objective: To explore the clinical value of blood routine parameters in evaluating the condition and predicting the prognosis of patients with CHF.Methods:447 patients with CHF admitted to the Heart Center of the first affiliated Hospital of Xinjiang Medical University from January 2017 to July 2018 were selected as the study group.The patients were divided into three groups according to their cardiac function: NYHA ?,NYHA ?,NYHA ?;Record their basic information at admission,blood routine(RDW,MPV,PDW,NEU,LYM,HCT,PLT,etc.and calculate NLR,PLR,NT-proBNP,hs-CRP,IL-6,echocardiography and other related indexes.The differences among different cardiac function groups were compared,and the relationship between blood routine related parameters and risk stratification of cardiac function was analyzed.The correlation between blood routine related parameters and LVEF was also studied.According to ejection fraction,the patients were divided into HFrEF group,HFmrEF group and HFpEF group,and to compare the differences of blood routine parameters in different ejection fraction groups.All CHF patients who were discharged were followed up to understand the death and readmission of patients after discharge.Receiver operating characteristics curve(ROC)analysis was drawn to predict the clinical value of blood routine related parameters in the occurrence of adverse cardiovascular events.Kaplan-Meier survival curve was drawn to analyze the survival of CHF patients.COX regression analysis was performed to assess the risk factors that affect the occurrence of terminal events in patients with CHF.Results:(1)NT-proBNP,RDW,MPV,PDW,NLR,and PLR levels gradually increased in patients with CHF,with a statistically significant difference(P<0.05).(2)Pearson correlation analysis showed that NT-proBNP,RDW,NLR,PDW,MPV,and PLR were negatively correlated with EF.The lower the LVEF,the higher the RDW,NLR,PDW,MPV,and PLR.(3)According to different ejection fractions,the RDW level of HFrEFgroup was significantly higher than that of HFmrEF group and HFpEF group.(4)According to ROC curve analysis,NT-proBNP,NLR,and RDW indicators have the ability to predict the occurrence of terminal events in patients.The AUC of NT-proBNP,NLR and RDW in predicting terminal events in patients with CHF were 0.775,0.773 and 0.690respectively(P<0.001).(5)Kaplan-Meier test analysis showed that patients with high NT-proBNP,NLR,and RDW groups had significantly higher rates of end-events.(6)Multivariate cox regression analysis showed that NT-proBNP,NLR and RDW were independent risk factors for terminal events,while other indexes had no effect on the prognosis of patients,and other indicators had no effect on patient prognosis.Conclusion:The worse the cardiac function of CHF patients,the more severe the disease,and the higher the levels of RDW,MPV,PDW,NLR,and PLR in blood routine parameters,they can be used to evaluate the condition of CHF patients.High levels of NLR and RDW are independent risk factors for terminal events in CHF patients.