[1]张兆元 马茜钰 张丹 彭石 张锦.C反应蛋白与高密度脂蛋白胆固醇比值、N末端脑钠肽前体与射血分数比值对STEMI患者PCI术后院内MACE的预测价值研究[J].心血管病学进展,2023,(2):186-192.[doi:10.16806/j.cnki.issn.1004-3934.2023.02.020]
　ZHANG ZhaoyuanMA QianyuZHANG DanPENG ShiZHANG Jin.The Predictive Value of C-reactive Protein to High Density Lipoprotein Cholesterol Ratio and NT-proBNP to Ejection Fraction Ratio for Hospital MACE in Patients with STEMI After PCI[J].Advances in Cardiovascular Diseases,2023,(2):186-192.[doi:10.16806/j.cnki.issn.1004-3934.2023.02.020]
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C反应蛋白与高密度脂蛋白胆固醇比值、N末端脑钠肽前体与射血分数比值对STEMI患者PCI术后院内MACE的预测价值研究()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2023年2期
页码:
186-192
栏目:
论著
出版日期:
2023-02-25

文章信息/Info

Title:
The Predictive Value of C-reactive Protein to High Density Lipoprotein Cholesterol Ratio and NT-proBNP to Ejection Fraction Ratio for Hospital MACE in Patients with STEMI After PCI
作者:
张兆元1 马茜钰1 张丹1 彭石1 张锦2
(1.兰州大学第一临床医学院,甘肃 兰州 730000;2.兰州大学第一医院心内科 甘肃省心血管疾病重点实验室,甘肃 兰州 730000)
Author(s):
ZHANG Zhaoyuan1MA Qianyu1ZHANG Dan1PENG Shi1ZHANG Jin2
(1.The First Clinical Medical College of Lanzhou UniversityLanzhou 730000GansuChina2.Department of CardiologyThe First Hospital of Lanzhou University/Gansu Provincial Key Laboratory of Cardiovascular DiseaseLanzhou 730000GansuChina)
关键词:
C反应蛋白与高密度脂蛋白胆固醇比值; N末端脑钠肽前体与射血分数比值; 急性ST段抬高型心肌梗死; 主要不良心血管事件; 影响因素
Keywords:
C-reactive protein to high density lipoprotein cholesterol ratio; N-terminal pro-brain natriuretic peptide to ejection fraction ratio; ST-segment elevation myocardial infarction; Major adverse cardiovascular event; Influence factor
DOI:
10.16806/j.cnki.issn.1004-3934.2023.02.020
摘要:
目的 探讨外周血C反应蛋白与高密度脂蛋白胆固醇比值（CHR）、N末端脑钠肽前体与射血分数比值（NER）与首次ST段抬高型心肌梗死（STEMI）患者冠状动脉病变严重程度的关系及对急诊经皮冠状动脉介入治疗（PCI）术后院内主要不良心血管事件（MACE）的预测价值。方法 回顾性纳入2019年8月—2021年2月在兰州大学第一医院心内科因首次发生STEMI住院的610例患者，根据PCI术后院内有无发生MACE分为MACE组和非MACE组。比较两组患者临床数据及CHR、NER的差异，采用多元线性回归分析CHR和NER与冠状动脉病变Gensini评分的关系。采用logistic回归模型分析STEMI患者PCI术后住院期间发生MACE的影响因素，并绘制受试者操作特征（ROC）曲线评估CHR、NER及其二者联合对院内发生MACE的预测价值。结果 MACE组的CHR、NER水平均高于非MACE组，差异有统计学意义（P＜0.001）。CHR、NER和冠状动脉多支病变与冠状动脉病变Gensini评分之间具有线性关系（P＜0.001）。CHR（OR＝1.021，95% CI 1.014～1.029）、NER（OR＝1.011，95% CI 1.005～1.017）是患者院内发生MACE的独立危险因素。ROC曲线分析，CHR预测MACE的曲线下面积（AUC）为0.843（95% CI 0.812～0.871，P＜0.05），截点值是23.904 8，敏感性是79.26%，特异性是76.42%；NER预测MACE的AUC为0.842（95% CI 0.810～0.870，P＜0.05），截点值是67.111 1，敏感性是69.63%，特异性是88.42%；二者联合预测MACE的AUC为0.875（95% CI 0.846～0.900，P＜0.05），截点值是0.172 3，敏感性是78.52%，特异性是84.42%。结论 外周血CHR和NER水平与首次STEMI患者冠状动脉病变严重程度呈线性关系，并具有辅助预测PCI术后住院期间发生MACE的价值。
Abstract:
Objective To explore the relationship of C-reactive protein to high density lipoprotein cholesterol ratio (CHR) and NT-proBNP to ejection fraction ratio (NER) with the severity of coronary lesions in patients firstly diagnosed with acute STEMI and their predictive value for MACE(heart failure ,cardiogenic shock,cardiac arrest,re-infarction,stroke,and hospital death) in hospital after primary PCI. Methods A total of 610 patients with first STEMI hospitalized in the Department of Cardiology,First Hospital of Lanzhou University from August 2019 to February 2021 were retrospectively enrolled,and divided into MACE and non-MACE groups according to the occurrence of MACE or not in hospital after primary PCI. The differences of clinical data ,CHR and NER were compared. Multiple linear regression was used to analyze the relationship of CHR,NER with coronary Gensini score. The influencing factors for MACE were calculated by Logistic regression model. The predictive value of CHR,NER or combined both for MACE during hospitalization was assessed by receiver operating characteristic(ROC) curve. Results The levels of CHR and NER were higher in MACE group than non-MACE group (all P＜0.001). There was a linear relationship between CHR,NER,multi-vessel lesions and coronary Gensini score (all P＜0.001). CHR(OR＝1.021,95% CI 1.014～1.029) and NER(OR＝1.011,95% CI 1.005～1.017) were independent risk factors for in-hospital MACE. ROC curve showed the area under curve(AUC) of CHR was 0.843 (95% CI 0.812～0.871,P＜0.05),with the cut-off value of 23.904 8,sensitivity of 79.26% and specificity of 76.42%. The AUC of NER was 0.842 (95% CI 0.810～0.870,P＜0.05),with the cut-off value of 67.111 1,sensitivity of 69.63% and specificity of 88.42%. The AUC of combined CHR and NER was 0.875 (95% CI 0.846～0.900,P＜0.05),with the cut-off value of 0.172 3,sensitivity of 78.52% and specificity of 84.42%. Conclusion The levels of CHR and NER in peripheral blood were linear with the severity of coronary lesions in patients with firstly diagnosed STEMI and concurrently of value in predicting MACE during hospitalization after primary PCI.

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更新日期/Last Update: 2023-03-23