目的:探讨中性粒细胞/高密度脂蛋白胆固醇比值(NHR)联合血小板/淋巴细胞比值 (PLR)对老年退行性心脏瓣膜病(SDHVD)患者瓣膜钙化的诊断价值。方法:选择2019年11月至2021年11月就诊于南通大学附属南通第三医院的229例心脏瓣膜钙化患者作为观察组,选取同期超声心动图结果正常的非心脏瓣膜钙化患者229例作为对照组。血常规分析仪及生化分析仪检测两组患者的指标,计算NHR、PLR,应用受试者工作特征曲线(ROC)评价NHR联合PLR在辅助诊断SDHVD瓣膜钙化中的价值。结果:观察组白细胞计数为6.21(5.25～7.99)×10⁹/L,高于对照组的5.83(4.54～7.25)×10⁹/L (P＜0.05)。观察组中性粒细胞计数为4.25(3.19～5.54)×10⁹/L,高于对照组3.52(2.70～4.79)×10⁹/L(P＜0.001)。观察组血小板计数为195.50(152.50～232.50)×10⁹/L,高于对照组175.00(138.00～213.00)×10⁹/L(P＜0.05),对照组高密度脂蛋白胆固醇1.21(0.98～1.49)mmol/L 高于观察组1.11(0.92～1.34)mmol/L(P＜0.05)。NHR观察组3.74(2.55～5.69)高于对照组3.07(2.13～4.29)(P＜0.001)。PLR观察组147.13 (107.99～196.54)高于对照组125.00(97.88～161.21) (P＜0.001)。ROC曲线结果显示,将4.56作为NHR阈值,曲线下面积为0.627,诊断SDHVD瓣膜钙化的敏感度和特异性分别为38.90 %和81.70 %;将138.98作为PLR阈值,曲线下面积为0.624,诊断SDHVD瓣膜钙化敏感度和特异性分别为57.60 %和60.30 %。联合NHR和PLR诊断SDHVD瓣膜钙化最佳截断值为280.66,曲线下面积为0.681,灵敏度和特异性分别为58.10 %和65.10 %。结论: SDHVD瓣膜钙化患者NHR和PLR均存在变化,NHR联合PLR可作为SDHVD瓣膜钙化辅助诊断的指标。

Objective: To investigate the diagnostic value of neutrophil/high-density lipoprotein cholesterol ratio (NHR) combined with platelet/lymphocyte ratio (PLR) in valvular calcification in elderly patients with degenerative heart valvular disease (SDHVD). Methods: A total of 229 patients with cardiac valve calcification treated from November 2019 to November 2021 were selected as the experimental group, and 229 patients with non-cardiac valve calcification with normal echocardiographic results during the same period were selected as the control group. Blood routine analyzer and biochemical analyzer were used to detect the indexes of the two groups of patients, and the NHR, PLR, NHR and PLR were calculated. Application of receiver operating characteristic curve (ROC) was to evaluate the value of NHR combined with PLR in the auxiliary diagnosis of valve calcification in SDHVD. Results: The white blood cell count in the experimental group was 6.21 (5.25～7.99)×10⁹/L, which was higher than that in the control group, which was 5.83(4.54～7.25)×10⁹/L (P=0.003). The neutrophil count in the experimental group was 4.25(3.19～5.54)×10⁹/L, which was higher than that in the experimental group, which was 3.52 (2.70～4.79) × 10⁹/L (P＜0.001). The platelet count in the experimental group was 195.50 (152.50～232.50)×10⁹/L, which was higher than that in the control group, which was 175.00(138.00～213.00)×10⁹/L, (P=0.001). The high density lipoprotein cholesterol of 1.21 (0.98 ~ 1.49) ×mmol/L in the control group was higher than that of 1.11 (0.92 ~ 1.34) ×mmol/L in the experimental group (P＜0.05). NHR 3.74 (2.55 ~ 5.69) in the experimental group was higher than 3.07 (2.13 ~ 4.29) in the control group (P＜0.001). PLR in the experimental group was 147.13 (107.99-196.54) higher than that in the control group (125.00 (97.88-161.21) (P＜0.001). ROC curve results showed that when 4.56 was taken as the threshold of NHR and the area under the curve was 0.627, the sensitivity and specificity of diagnosing SDHVD valve calcification were 38.90 % and 81.70 %, respectively. Using 138.98 as the PLR threshold, the area under the curve was 0.624, and the sensitivity and specificity for the diagnosis of SDHVD valve calcification were 57.60 % and 60.30 %, respectively. Combined with NHR and PLR in the diagnosis of SDHVD valve calcification, the optimal cut-off value was 280.66, the area under the curve was 0.681, and the sensitivity and specificity were 58.10 % and 65.10 %, respectively. Conclusion: There are changes in NHR and PLR in patients with SDHVD valve calcification. NHR combined with PLR can be used as an auxiliary diagnostic indicator for SDHVD valve calcification.