sibmedСибирский научный медицинский журналСибирский научный медицинский журнал2410-25122410-2520ИЦиГ СО РАН10.15372/SSMJ20200609sibmed-522Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEРоль гематологических показателей в качестве предикторов летального исхода у пациентов пожилого и старческого возраста в госпитальном периодеThe role of hematological parameters as predictors of mortality in elderly patients in the hospital periodhttps://orcid.org/0000-0001-7016-4463БорисоваЛ. В.BorisovaL. V.

Людмила Викторовна Борисова

197110, Санкт-Петербург, просп. Динамо, 3; 194354, Санкт-Петербург, Учебный пер., 5

Lyudmila V. Borisova

St. Petersburg, Dinamo av., 3; St. Petersburg, Uchebnyj lane, 5

lucibor@yandex.ruhttps://orcid.org/0000-0002-8161-2425РукавишниковаС. А.RukavishnikovaS. A.

Светлана Александровна Рукавишникова - доктор биологических наук, профессор.

194354, Санкт-Петербург, Учебный пер., 5; 197022, Санкт-Петербург, ул. Льва Толстого, 6-8

Svetlana A. Rukavishnikova - Doctor of Biological Sciences, Professor.

St. Petersburg, Uchebnyj lane, 5; St. Petersburg, Lev Tolstoy str., 6-8

kdlb2@yandex.ruhttps://orcid.org/0000-0003-2875-9521ПушкинА. С.PushkinA. S.

Александр Сергеевич Пушкин - кандидат медицинских наук.

197110, Санкт-Петербург, просп. Динамо, 3; 194354, Санкт-Петербург, Учебный пер., 5; 197022, Санкт-Петербург, ул. Льва Толстого, 6-8

Alexander S. Pushkin - Candidate of Medical Sciences.

St. Petersburg, Dinamo av., 3; St. Petersburg, Uchebnyj lane, 5; St. Petersburg, Lev Tolstoy str., 6-8

pushkindoc@mail.ruhttps://orcid.org/0000-0002-3105-4322АхмедовТ. А.AhmedovT. A.

Тимур Артыкович Ахмедов - кандидат медицинских наук.

194354, Санкт-Петербург, Учебный пер., 5; 197022, Санкт-Петербург, ул. Льва Толстого, 6-8

Timur A. Akhmedov - Candidate of Medical Sciences.

St. Petersburg, Uchebnyj lane, 5; St. Petersburg, Lev Tolstoy str., 6-8

timaxm@gmail.ruhttps://orcid.org/0000-0001-5310-0812ЯковлевВ. В.YakovlevV. V.

Владимир Валерьевич Яковлев - доктор медицинских наук.

194044, Санкт-Петербург, ул. Академика Лебедева, 6

Vladimir V. Yakovlev - Doctor of Medical Sciences.

St. Petersburg, Akademik Lebedev str., 6

yakovlev-mma@yandex.ruНИЦ Санкт-Петербургский Институт биорегуляции и геронтологии; Городская многопрофильная больница № 2РоссияSaint-Petersburg Institute of Bioregulation and Gerontology; City multidisciplinary hospital № 2Russian FederationГородская многопрофильная больница № 2; Первый Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова Минздрава РоссииРоссияCity multidisciplinary hospital № 2; First Pavlov State Medical University of St. Petersburg of Minzdrav of RussiaRussian FederationНИЦ Санкт-Петербургский Институт биорегуляции и геронтологии; Городская многопрофильная больница № 2; Первый Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова Минздрава РоссииРоссияSaint-Petersburg Institute of Bioregulation and Gerontology; City multidisciplinary hospital № 2; First Pavlov State Medical University of St. Petersburg of Minzdrav of RussiaRussian FederationВоенно-медицинская академия им. С.М. КироваРоссияMilitary medical Academy of S.M. KirovRussian Federation2020261220204068998Copyright © Борисова Л.В., Рукавишникова С.А., Пушкин А.С., Ахмедов Т.А., Яковлев В.В., 20202020Борисова Л.В., Рукавишникова С.А., Пушкин А.С., Ахмедов Т.А., Яковлев В.В.Borisova L.V., Rukavishnikova S.A., Pushkin A.S., Ahmedov T.A., Yakovlev V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://sibmed.elpub.ru/jour/article/view/522

Актуальность разработки алгоритмов прогноза неблагоприятных исходов, в том числе летального исхода у пациентов пожилого и старческого возраста, не вызывает сомнений. Среди потенциальных предикторов рассматриваются гематологические показатели. Клинический анализ крови - один из наиболее доступных методов диагностики в практической медицине, отражающий системные патологические процессы в организме человека на основе количественной оценки ее клеточного состава и морфологии. Целью настоящего исследования было оценить гематологические показатели в качестве предикторов летального исхода на госпитальном этапе у пациентов пожилого и старческого возраста с острым коронарным синдромом (ОКС).

Материал и методы

Материал и методы. В исследование включено 277 пациентов с ОКС. Гематологические показатели регистрировали с использованием анализатора CELL-DYN Sapphire (Abbott Laboratories, США), в том числе рассчитывали нейтрофильно-лимфоцитарный и тромбоцитарно-лимфоцитарный индексы.

Результаты

Результаты. Увеличение общего количества лейкоцитов (более 10,45 × 109/л) у пациентов с ОКС в возрасте 60-74 лет при госпитализации связано с более высоким риском развития летального исхода на госпитальном этапе. Среди пациентов с ОКС в возрасте 75-89 лет риск летального исхода сопряжен со следующими изменениями в периферической крови при поступлении: абсолютное количество эозинофилов менее 0,086 × 109/л, абсолютное количество базофилов более 0,079 × 109/л и тромбоцитарно-лимфоцитарный индекс ниже 31,06.

The development of algorithms for predicting adverse outcomes, including death in elderly and senile patients, is an urgent issue. Potential predictors include hematologic parameters. A clinical blood test is one of the most affordable diagnostic methods in practical medicine, reflecting systemic pathological processes in the human body based on a quantitative assessment of the cellular composition and blood morphology. The aim of this study was to evaluate hematological parameters as predictors of in-hospital mortality in patients of the elderly and senile age with acute coronary syndrome.

Material and methods

Material and methods. The study included 277 patients with acute coronary syndrome. The study of hematological parameters was carried out on a CELL-DYN Sapphire hematology analyzer (Abbott Laboratories, USA). The values of neutrophil-lymphocytes ratio and platelet-lymphocytes ratio were also evaluated as predictors of in-hospital mortality.

Results

Results. High content of leukocytes (above 10.45 x 109/l) during hospitalization in patients with ACS aged 60-74 years are associated with a higher risk of death at the hospital stage. Among patients with ACS aged 75-89 years, the risk of death is associated with the following changes in peripheral blood upon admission: a decrease in the absolute number of eosinophils below 0.086 x 109/l, an increase in the absolute number of basophils above 0.079 x 109/l and a decrease in platelet-lymphocytes ratio below 31.06.

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The authors declare that there are no conflicts of interest present.