[1]李荣富 王高生 何宗保 范西真.HEART评分联合NLR对NSTE-ACS患者MACE的预测价值[J].心血管病学进展,2023,(1):92-96.[doi:10.16806/j.cnki.issn.1004-3934.2023.01.020]
　LI Rongfu,WANG Gaosheng,HE Zongbao,et al.The Predictive Value of HEART Score Combined with NLR for MACE in Patients with NSTE-ACS[J].Advances in Cardiovascular Diseases,2023,(1):92-96.[doi:10.16806/j.cnki.issn.1004-3934.2023.01.020]
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HEART评分联合NLR对NSTE-ACS患者MACE的预测价值()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2023年1期
页码:
92-96
栏目:
论著
出版日期:
2023-01-25

文章信息/Info

Title:
The Predictive Value of HEART Score Combined with NLR for MACE in Patients with NSTE-ACS
作者:
李荣富 王高生 何宗保 范西真
(中国科学技术大学附属第一医院 安徽省立医院南区急诊科,安徽 合肥 230001)
Author(s):
LI Rongfu; WANG Gaosheng; HE Zongbao; FAN Xizhen
(Department of Emergency,The First Affiliated Hospital of University of Science and Technology of China,Anhui Provincial Hospital,Hefei 230001,Anhui,China)
关键词:
HEART评分; 中性粒细胞与淋巴细胞比值; 非ST段抬高型急性冠脉综合征; 主要不良心血管事件
Keywords:
HEART score; Neutrophil to lymphocyte ratio; Non-ST segment elevation acute coronary syndrome; Major adverse cardiovascular events
DOI:
10.16806/j.cnki.issn.1004-3934.2023.01.020
摘要:
目的 评估HEART评分联合中性粒细胞与淋巴细胞比值（NLR）对非ST段抬高型急性冠脉综合征（NSTE-ACS）患者3个月内发生主要不良心血管事件（MACE）的风险预测价值。方法 收集2021年1—12月在安徽省立医院急诊科就诊的符合NSTE-ACS诊断标准的成年急性胸痛患者（共164例）的临床资料、首次心电图、肌钙蛋白及血细胞计数，通过电话随访的方式了解患者3个月内是否发生MACE。根据有无MACE发生将NSTE-ACS患者分为MACE组及无MACE组，比较两组患者的HEART评分及NLR水平；根据HEART评分将NSTE-ACS患者分为低危组、中危组及高危组，比较各组间的NLR水平及MACE发生率；通过有序逻辑回归分析NSTE-ACS患者发生MACE的危险预测因子；绘制受试者操作特征曲线（ROC曲线）分析对比HEART评分、NLR水平及二者联合对NSTE-ACS患者发病3个月内发生MACE的预测价值。结果 MACE组患者HEART评分、NLR水平和肌钙蛋白水平均高于无MACE组（P均＜0.001）；HEART评分危险分层越高，NLR水平及MACE发生率均越高（P均＜0.05）；HEART评分（OR＝1.822，95% CI 1.616～2.052）和NLR（OR＝1.081，95% CI 1.059～1.112）是NSTE-ACS患者发生MACE的独立危险预测因子；HEART评分、NLR及二者联合对NSTE-ACS患者3个月内发生MACE的ROC曲线下面积分别为0.827、0.802和0.862。结论 HEART评分联合NLR可在一定程度上提高HEART评分对NSTE-ACS患者发病3个月内MACE的风险预测能力。
Abstract:
Objective To evaluate the predictive value of HEART score combined with neutrophil to lymphocyte ratio(NLR) on the risk of major adverse cardiovascular events(MACE) within 3 months in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS). Methods Adult patients with acute chest pain(a total of 164 cases) who met the diagnostic criteria for NSTE-ACS in the emergency department of Anhui Provincial Hospital from January 2021 to December 2021 were enrolled,and the data of all patients’ general clinical information,first electrocardiogram,cardiac troponin,and the count of blood cell were collected. All the patients were followed up by telephone to know whether MACE occurred within 3 months. The NSTE-ACS patients were divided into the MACE group and the non-MACE group according to whether there was MACE,and the HEART score and NLR level of the two groups were compared. According to the HEART score,the patients with NSTE-ACS were divided into low risk group,medium risk group and high risk group,and the NLR level and the incidence of MACE among the groups were compared. The risk predictors of MACE in patients with NSTE-ACS were analyzed by ordered logistic regression. The receiver operator characteristic(ROC) curve was drawn to evaluate the predictive value of HEART score,NLR and their combination for 3-month MACE in patients with NSTE-ACS. Results The level of HEART score,NLR and cardiac troponin in the MACE group were significantly higher than those in the non-MACE group (all P<0.001). The higher the risk stratification of HEART score, the higher the NLR level and the incidence of MACE(all P<0.05). HEART score（OR＝1.822，95% CI 1.616～2.052）and NLR（OR＝1.08195% CI 1.059～1.112）were the independent risk predictor of MACE in patients with NSTE-ACS. The area under the ROC curve of the patients with NSTE-ACS who had MACE within 3 months was 0.827, 0.802 and 0.862 respectively by HEART score,NLR and their combination. Conclusion HEART score combined with NLR can improve the ability of HEART score to predict the risk of MACE in NSTE-ACS patients within 3 months after onset

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更新日期/Last Update: 2023-03-10