探讨外周血尿酸肌酐比值（UA/Cr）结合中性粒细胞/淋巴细胞比值（NLR）及N末端B型脑钠肽前体（NT-proBNP）对肺癌患者围手术期急性心力衰竭（AHF）的预测价值。

选取2022年1月至2024年12月接受肺癌手术治疗患者186例进行回顾性队列研究，其中男性113例，女性73例；年龄41~78岁，平均（61.19±8.41）岁。根据患者围手术期是否发生AHF，分为AHF组（31例）和非AHF（155例），比较两组的临床基线资料，采用多因素回归分析肺癌患者围手术期发生AHF的影响因素，并应用受试者工作特征曲线（ROC）曲线分析各因素对肺癌患者围手术期发生AHF的预测价值。

两组患者在病理分期、纽约心脏病协会（NYHA）心功能分级、UA/Cr、NLR和NT-proBNP上相比，差异均有统计学意义（P<0.05）。多因素回归分析显示：血UA/Cr、NLR和NT-proBNP均是肺癌患者围手术期发生AHF的危险因素（P<0.05）。ROC曲线分析结果显示血UA/Cr诊断肺癌患者围手术期AHF的截断值为16.69，AUC为0.829（95% CI0.749~0.909），敏感度为74.20%，特异度为78.70%；NLR截断值为2.205，AUC为0.856（95% CI0.777~0.935），敏感度为90.30%，特异度为66.50%；NT-proBNP截断值为2 099.495 ng/L，曲线下面积（AUC）为0.903（95%CI0.833~0.972），敏感度为71.00%，特异度为98.70%；联合诊断AUC为0.986（95%CI0.970~1.000），敏感度为96.80%，特异度为94.80%。

外周血UA/Cr比值、NLR及NT-proBNP联合诊断对肺癌患者围手术期发生AHF具有一定的预测价值，敏感性和特异性均较高。

To explore the predictive value of peripheral blood uric acid (UA)/creatinine (Cr) ratio, neutrophil/lymphocyte ratio (NLR), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in acute heart failure (AHF) during the perioperative period of lung cancer patients.

A retrospective cohort study was conducted on 186 patients who underwent surgical treatment for lung cancer from January 2022 to December 2024, including 113 males and 73 females; the age ranged from 41 to 78 years, with an average of (61.19±8.41) years. According to whether patients experienced AHF during the perioperative period, they were divided into AHF group (31 cases) and non AHF group (155 cases). The clinical baseline data of the two groups were compared, and multiple regression analysis was used to analyze the influencing factors of AHF in lung cancer patients during the perioperative period, the receiver operating characteristic (ROC) curve was applied to analyze the predictive value of each factor for AHF in lung cancer patients during the perioperative period.

There were significant differences in pathological stage, NYHA cardiac function grade, UA/Cr, NLR and NT-proBNP between two groups (P<0.05). Multivariate regression analysis showed that blood UA/Cr, NLR and NT-proBNP were all risk factors for perioperative AHF in lung cancer patients (P<0.05). ROC curve analysis showed that the cutoff value of serum UA/Cr in diagnosing perioperative AHF was 16.69, AUC was 0.829 (95%CI0.749-0.909), sensitivity was 74.20%, and specificity was 78.70%. The cut-off value of NLR was 2.205, AUC was 0.856 (95%CI: 0.777-0.935), sensitivity was 90.30%, and specificity was 66.50%. The cut-off value of NT-proBNP was 2 099.495 ng/L, the area under the working characteristic curve (AUC) of the subjects was 0.903 (95%CI: 0.833-0.972), with a sensitivity of 71.00% and a specificity of 98.70%; The combined diagnostic AUC was 0.986 (95%CI: 0.970-1.000), with a sensitivity of 96.80% and a specificity of 94.80%.

The combined diagnosis of peripheral blood UA/Cr ratio, NLR and NT-proBNP has a certain predictive value for perioperative AHF in lung cancer patients, with high sensitivity and specificity.