Absolute blood eosinophil count and 1-year mortality risk following hospitalization with acute heart failure
Absolute blood eosinophil count and 1-year mortality risk following hospitalization with acute heart failure
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DOI：
10.1097/mej.0b013e32834c67eb
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发表时间：
2012-08-01
影响因子：
4.4
通讯作者：
Tukek, Tufan
中科院分区：
文献类型：
--
作者：
Cikrikcioglu, Mehmet Ali;Soysal, Pinar;Tukek, Tufan
目的在急性心力衰竭（AHF）中，血红蛋白、红细胞分布宽度、平均血小板体积、白细胞和相对淋巴细胞计数与死亡率相关。目前尚不清楚绝对血液中性粒细胞、嗜酸性粒细胞和单核细胞计数是否为死亡率预测因子。方法对176例AHF住院患者进行分析。排除了影响白细胞计数的治疗方式和合并症。血象、前脑利钠肽、d -二聚体、生化、甲状腺激素、敏感c反应蛋白、超声心动图。确定住院后第一年的心血管死亡。结果死亡患者白细胞和绝对中性粒细胞计数明显高于存活患者，绝对淋巴细胞计数和绝对嗜酸性粒细胞计数（AEC）明显低于存活患者。各组在单核细胞计数方面相似。BMI白蛋白、估计肾小球滤过率、游离T3、射血分数显著降低，铁蛋白、尿酸、d -二聚体、前脑利钠肽显著升高。二尖瓣反流、低血压、低钠血症和急性肾功能衰竭在死者组中也明显更常见。采用显著变量的二元logistic回归分析显示，较低的BMI、较低的射血分数、低钠血症、较低的游离T3和较低的AEC是死亡的独立预测因子，总体上是81.8%心血管死亡的原因。AEC为0.02 n/l × 10(9)或更低的患者的死亡率比AEC大于0.02 n/l × 10(9)的患者高4.4倍。结论AHF患者入院时测量的AEC比所有其他血象参数更能预测死亡率，这与交感神经-肾上腺活动增加理论相一致。欧洲急诊医学杂志：257-263 (C) 2012 Wolters Kluwer Health垂直bar Lippincott Williams & Wilkins。
Objective In acute heart failure (AHF), hemoglobin, red cell distribution width, mean platelet volume, leukocytes, and relative lymphocyte count have been associated with mortality. It is not known whether absolute blood neutrophil, eosinophil, and monocyte counts are mortality predictors.Methods One hundred and seventy-six patients hospitalized due to AHF were enrolled. Treatment modalities and comorbidities influencing leukocyte counts were excluded. Hemogram, pro-brain natriuretic peptide, D-dimer, biochemistry, thyroid hormones, sensitive C-reactive protein, and echocardiography were obtained. Cardiovascular deaths during the first year after hospitalization were determined.Results Leukocyte and absolute neutrophil count were significantly higher and absolute lymphocyte count and absolute eosinophil count (AEC) were significantly lower in deceased patients than patients who survived. Groups were similar in terms of monocyte counts. BMI albumin, estimated glomerular filtration rate, free T3, ejection fraction were significantly lower, and ferritin, uric acid, D-dimer, pro-brain natriuretic peptide were significantly higher in deceased patients. Mitral regurgitation, hypotension, hyponatremia, and acute renal failure were also significantly more frequent among the deceased group. Binary logistic regression analysis employing significant variables showed that lower BMI, lower ejection fraction, hyponatremia, lower free T3, and lower AEC were independent predictors of death and as a whole were responsible from 81.8% of cardiovascular deaths. Death rate among patients with an AEC of 0.02 n/l x 10(9) or less was 4.4-fold higher than patients with an AEC of more than 0.02 n/l x 10(9).Conclusion AEC of AHF patients measured at admission was found to be a stronger predictor of mortality than all other hemogram parameters and this is consistent with the increased sympatho-adrenal activity theory. European Journal of Emergency Medicine 19:257-263 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.