Abstract:

Objective　To explore the relationships between neutrophil count (NEUT), erythrocyte sedimentation rate (ESR), and galectin-3 (Gal-3) levels and clinical prognosis in patients with infective endocarditis (IE). Methods　Eighty-eight patients with IE were selected from Shangluo Central Hospital from February 2021 to April 2023, including 49 males and 39 females, with an average age of 46.20 years old, 54 cases of grade Ⅱ-Ⅲ and 34 cases of grade Ⅳ. They were followed up for one year. Based on the prognosis results, the patients were divided into a good prognosis group (54 cases) and a poor prognosis group (34 cases). Univariate analysis was used to analyze the patients' clinical data and laboratory indicators. Subsequently, multivariate logistic regression analysis was conducted to identify the risk factors for poor prognosis. The receiver operating characteristic curve (ROC) was used to evaluate the predictive capability of NEUT, ESR, and Gal-3 levels for the poor prognosis of IE patients. t test and χ² test were used. Results　There were statistically significant differences in the cardiac function grade, Pitt score, NEUT level before treatment, and NEUT, ESR, and Gal-3 levels after 2 weeks of treatment between the poor prognosis group and the good prognosis group (all P<0.05). Multivariate logistic regression analysis showed that cardiac function grade Ⅳ, Pitt score ≥2, and high NEUT, ESR, and Gal-3 levels after 2 weeks of treatment were independent risk factors for poor prognosis in IE patients (all P<0.05). The areas under the curves (AUC) of NEUT, ESR, and Gal-3 levels after 2 weeks of treatment and their combination in predicting poor prognosis in IE patients were 0.912, 0.949, 0.905, and 0.985, respectively. Conclusions　NEUT, ESR, and Gal-3 levels have significant clinical predictive value in IE patients. High levels of NEUT, ESR, and Gal-3 are closely related to poor prognosis in IE patients and can serve as independent risk factors for poor prognosis. These markers can provide more accurate risk assessment and decision support for clinical treatment.

Key words:

Infective endocarditis, Neutrophil count, Erythrocyte sedimentation rate, Galectin-3, Prognostic prediction

摘要：

目的　探讨中性粒细胞计数（neutrophil count，NEUT）、红细胞沉降率（erythrocyte sedimentation rate，ESR）、半乳糖凝集素-3（galectin-3，Gal-3）水平与感染性心内膜炎（infective endocarditis，IE）患者临床预后的关系。方法　选取2021年2月至2023年4月商洛市中心医院收治的88例IE患者，其中男49例，女39例，平均年龄46.20岁，心功能分级Ⅱ～Ⅲ级54例、Ⅳ级34例。随访1年，根据预后结果，将患者分为预后良好组（54例）和预后不良组（34例）。单因素分析患者的临床资料和实验室指标等，然后通过多因素logistic回归分析IE患者预后不良的危险因素。受试者操作特征曲线（ROC）评估NEUT、ESR和Gal-3水平对IE患者预后不良的预测能力。采用t检验、χ²检验。结果　预后不良组与预后良好组心功能分级、Pitt评分、治疗前NEUT水平、治疗2周后NEUT、ESR和Gal-3水平比较，差异均有统计学意义（均P<0.05）。多因素logistic回归分析结果显示，心功能分级为Ⅳ级、Pitt评分≥2分及治疗2周后高NEUT、ESR和Gal-3水平是IE患者预后不良的独立危险因素（均P<0.05）。治疗2周后NEUT、ESR和Gal-3水平及三者联合预测IE患者预后不良的曲线下面积（AUC）分别为0.912、0.949、0.905和0.985。结论　NEUT、ESR、Gal-3水平在IE患者中具有重要的临床预测价值。高水平的NEUT、ESR和Gal-3与IE患者的不良预后密切相关，可以作为独立的不良预后风险因素，能够为临床提供更精准的风险评估和治疗决策支持。

关键词:

感染性心内膜炎, 中性粒细胞计数, 红细胞沉降率, 半乳糖凝集素-3, 预后预测