2025 年第 9 期 第 20 卷

D-二聚体与纤维蛋白原比值和C反应蛋白与纤维蛋白原比值与老年慢性心力衰竭急性加重患者临床预后的关系研究

The relationship between D-dimer/fibrinogen ratio and C-reactive protein/fibrinogen ratio and clinical prognosis in elderly patients with acute exacerbation of chronic heart failure

作者：贺翠张晓玲

英文作者：He Cui Zhang Xiaoling

单位：重庆大学附属涪陵医院心血管内科，重庆408000

英文单位：Department of Cardiology Chongqing University Fuling Hospital Chongqing 408000 China

关键词：慢性心力衰竭急性加重；D-二聚体与纤维蛋白原比值；C反应蛋白与纤维蛋白原比值

英文关键词：Acuteexacerbationofchronicheartfailure；D-dimer/fibrinogenratio；C-reactiveprotein/fibrinogenratio

• 摘要：

• 目的 探讨D-二聚体与纤维蛋白原比值（DFR）、C反应蛋白与纤维蛋白原比值（CFR）与老年慢性心力衰竭急性加重（AECHF）患者临床预后的关系。方法 回顾性收集2020年5月至2024年5月重庆大学附属涪陵医院收治的157例AECHF患者临床资料，计算DFR、CFR，统计AECHF患者入院后90 d内死亡和因心力衰竭再次住院发生情况。根据AECHF患者预后分为预后良好组（105例）和预后不良组（52例）。分析影响AECHF患者预后不良的危险因素，以及DFR、CFR预测AECHF患者预后不良的价值。结果 预后不良组DFR、CFR高于预后良好组［（0.20±0.05）比（0.18±0.03）、（3.3±0.7）比（2.6±0.4）］（均P＜0.05）。纽约心脏病协会心功能分级Ⅳ级、N末端B型脑钠肽前体（NT-proBNP）、DFR、CFR是AECHF患者预后不良的危险因素（均P＜0.05）。联合DFR、CFR和NT-proBNP预测AECHF患者预后不良的曲线下面积高于DFR、CFR和NT-proBNP单独预测（Z=3.861、3.452、2.853，均P＜0.05）。结论 AECHF患者DFR和CFR增高与预后不良有关，联合DFR、CFR和NT-proBNP在AECHF预后分析中有较高价值。

• Objective To investigate the relationship between D-dimer/fibrinogen ratio(DFR) and C-reactive protein/fibrinogen ratio(CFR) and clinical prognosis in elderly patients with acute exacerbation of chronic heart failure(AECHF). Methods The clinical data of 157 patients with AECHF admitted to Chongqing University Fuling Hospital from May 2020 to May 2024 were retrospectively collected. DFR and CFR were calculated, and the death and rehospitalization due to heart failure within 90 days after admission of AECHF patients were counted. According to the prognosis of AECHF patients, they were divided into good prognosis group (105 cases) and poor prognosis group (52 cases). The risk factors for the poor prognosis of patients with AECHF were analyzed, and the value of DFR and CFR in predicting the poor prognosis of patients with AECHF was analyzed. Results DFR and CFR in the poor prognosis group were higher than those in the good prognosis group ［(0.20±0.05) vs (0.18±0.03), (3.3±0.7) vs (2.6±0.4)］(both P＜0.05). New York Heart Association class Ⅳ, N-terminal pro-brain natriuretic peptide (NT-proBNP), DFR and CFR were risk factors for poor prognosis in patients with AECHF (all P＜0.05). The area under the ROC curve of combined DFR, CFR and NT-proBNP for predicting poor prognosis in AECHF patients was higher than that of DFR, CFR or NT-proBNP alone (Z=3.861, 3.452, 2.853, all P＜0.05). Conclusion Increased DFR and CFR are associated with poor prognosis in patients with AECHF. The combination of DFR, CFR and NT-proBNP has a high prognostic value in patients with AECHF.