保健医学研究与实践2026，Vol.23Issue(7)：37-43,59,8.DOI:10.11986/j.issn.1673-873X.2026.07.06
慢性心功能不全急性加重期患者AST/ALT、NLR、PLR水平及临床意义
Levels and clinical significance of AST/ALT,NLR,and PLR in patients with acute decompensated chronic heart failure
摘要
Abstract
Objective To investigate the changes and clinical value of aspartate aminotransferase-to-alanine aminotransferase ratio(AST/ALT),neutrophil-to-lymphocyte ratio(NLR),and platelet-to-lymphocyte ratio(PLR)in patients with acute decompensated heart failure(ADHF).Methods A total of 118 patients with ADHF admitted to The Third People's Hos-pital of Chengdu from January 2022 to December 2024 were retrospectively selected as the ADHF group,and 100 patients with stable chronic heart failure(CHF)were selected as the control group.The levels of AST/ALT,NLR,and PLR were compared between the two groups,and Spearman correlation analysis was used to explore the correlations of these indicators with myocardial injury markers(N-terminal pro-brain natriuretic peptide[NT-proBNP]and lactate dehydrogenase[LDH]).After 6 months of follow-up,patients with ADHF were assigned to a poor prognosis group(n=50)and a good prognosis group(n=68)according to prognosis.The levels of AST/ALT,NLR,and PLR were compared between patients with different prognoses.Receiver operating characteristic(ROC)curves and area under the curve(AUC)were adopted to analyze the predictive value of each indicator for the prognosis of ADHF patients.Results The levels of AST/ALT,NLR,PLR,NT-proBNP,and LDH in the ADHF group were significantly higher than those in the control group(Z/t=12.003,19.282,32.917,29.679,12.714;P<0.001).Spearman correlation analysis showed that serum AST/ALT,NLR,and PLR levels in ADHF patients were positively correlated with NT-proBNP and LDH levels(P<0.05).The levels of AST/ALT,NLR,and PLR in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).ROC curve analysis showed that the AUCs of AST/ALT,NLR,and PLR for predicting poor prognosis in ADHF patients were 0.823(95%CI:0.747-0.899),0.820(95%CI:0.744-0.896),and 0.810(95%CI:0.732-0.887),re-spectively.The AUC of the combination of the three indicators for predicting poor prognosis in ADHF patients was 0.958(95%CI:0.926-0.989),which was higher than that of each indicator alone(Z=3.726,3.829,4.025;P<0.001).Con-clusion The levels of AST/ALT,NLR,and PLR are abnormally elevated in patients with ADHF,and all have high predic-tive performance for patient prognosis,with the combined detection indicating even higher predictive performance.Clinical-ly,dynamic monitoring of the changes in these three indicators can help identify highrisk populations early and conduct tar-geted interventions,thereby improving patient outcomes.关键词
慢性心功能不全/急性加重期/谷草转氨酶/谷丙转氨酶比值/中性粒细胞与淋巴细胞比值/血小板与淋巴细胞比值/预测价值Key words
Chronic heart failure/Acute exacerbation/AST/ALT ratio/Neutrophil-to-lymphocyte ratio/Platelet-to-lympho-cyte ratio/Predictive value分类
医药卫生引用本文复制引用
张人予,郑永玲,李璐娜,钟倩,王月书,周琴,刘晶晶..慢性心功能不全急性加重期患者AST/ALT、NLR、PLR水平及临床意义[J].保健医学研究与实践,2026,23(7):37-43,59,8.基金项目
四川省科技计划项目(2023YFS0298). （2023YFS0298）
