HALP评分与老年高龄冠心病患者发生慢性 心力衰竭相关性

HALP Score Correlates with the Development of Chronic Heart Failure in Elderly Patients with Coronary Heart Disease

摘要: 目的：心力衰竭(heart failure, HF)在老年人群中高发病率，严重影响生活质量，表现为频繁住院和高死亡率。血红蛋白、白蛋白、淋巴细胞和血小板评分(the hemoglobin, albumin, lymphocyte, and platelet score, HALP)已成为反映营养和炎症状态的综合标志物，但其在老年高龄人群环境中心力衰竭发生率尚未充分探讨，因此，我们的研究探讨了HALP评分与老年高龄冠心病(coronary heart disease, CHD)患者发生心力衰竭的相关性及其对心力衰竭的预测价值。方法：本研究为一项回顾性研究，收集2023年1月~2025年6就诊于河北省人民医院的高龄老年CHD患者(≥75岁) 394例，通过医院电子病例系统收集患者入院时的各项检查指标，并计算其HALP评分，按有无慢性心力衰竭疾病分组。采用SPSS 27.0统计软件。首先进行单因素分析筛选潜在影响因素，再将有统计学意义的变量纳入多因素Logistic回归，分析HALP与心衰的独立关联。结果：入组了394例患者。心衰组204例，非心衰组190例，调整了包括高尿酸血症病史、房颤病史、脑血管病史、心脏瓣膜病病史、血小板计数、血总蛋白水平、空腹血糖水平、血尿酸水平等协变量后，我们发现HALP评分与心力衰竭发生率呈负相关OR为0.333 (95%CI: 0.142~0.782)。与高HALP评分患者相比，HALP评分较低的患者发生心力衰竭的风险更高。此外，HALP对心力衰竭发生具有较好的预测价值。结论：老年高龄CHD患者中，HALP评分与其HF的发生存在一定相关性，其水平降低是该人群发生HF的独立相关因素；HALP评分对老年高龄CHD患者发生HF可能有一定的诊断价值。

Abstract: Objective: Heart failure (HF) is highly prevalent among the elderly, severely compromising quality of life and presenting with frequent hospitalizations and high mortality. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score is a composite biomarker reflecting nutritional status and inflammatory responses. However, its association with HF incidence in the very elderly population remains insufficiently explored. This study aimed to investigate the correlation between the HALP score and HF development, as well as its predictive value, in very elderly patients with coronary heart disease (CHD). Methods: A retrospective study was conducted involving 394 CHD patients aged ≥ 75 years who were admitted to Hebei General People’s Hospital from January 2023 to June 2025. Laboratory parameters at admission were extracted from the electronic medical record system to calculate the HALP score. Patients were divided into two groups according to the presence or absence of HF. Statistical analyses were performed using SPSS software (version 27.0). Univariate analysis was first carried out to identify potential influencing factors, followed by incorporation of statistically significant variables into a multivariate logistic regression model to evaluate the independent association between the HALP score and HF. Results: Among the 394 enrolled patients, 204 were assigned to the HF group and 190 to the non-HF group. After adjusting for confounding factors including a history of hyperuricemia, atrial fibrillation, cerebrovascular disease, valvular heart disease, platelet count, serum total protein level, fasting plasma glucose level, and serum uric acid level, the HALP score was negatively correlated with HF incidence (OR = 0.333, 95%CI: 0.142~0.782). Patients with lower HALP scores had a significantly higher risk of HF compared to those with higher scores. Furthermore, the HALP score exhibited good predictive value for HF occurrence. Conclusion: In very elderly CHD patients, the HALP score is associated with HF occurrence, and a decreased HALP score is an independent risk factor for HF in this population. The HALP score may hold certain predictive value for HF in very elderly patients with coronary heart disease.