老年人营养风险指数预测急性ST段抬高型心肌梗死患者经皮冠状动脉介入治疗的预后  

Geriatric Nutritional Risk Index predicts clinical outcome in patients with acute ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

作　　者：周欣荣[1,2] 陈清杰 赵龙 李晓梅[1,2] 刘芬[1,2,3] 向阳 赵倩[1,2] 陈邦党 翟慧[1,2] 马依彤 杨毅宁[1,2] ZHOU Xinrong;CHEN Qingjie;ZHAO Long;LI Xiaomei;LIU Fen;XIANG Yang;ZHAO Qian;CHEN Bangdang;ZHAI Hui;MA Yitong;YANG Yining(Department of Cardiology,the First Affiliated Hospital of Xinjiang Medical University;Xinfiang Key Laboratory of Car-diovascular Disease Research;Clinical Research Institute,the First Affiliated Hospital of Xinfiang Medical University,Urumqi,Xinjiang 83000,China)

机构地区：[1]新疆医科大学第一附属医院心脏中心 [2]新疆乌鲁木齐市新疆心血管重点实验室 [3]新疆医科大学第一附属医院临床研究院,新疆乌鲁木齐市830000

出　　处：《中国动脉硬化杂志》2018年第9期906-912,共7页Chinese Journal of Arteriosclerosis

基　　金：国家自然科学基金项目(U1503322)

摘　　要：目的旨在调查老年人营养风险指数（GNRI）是否与接受经皮冠状动脉介入治疗（PCI）急性ST段抬高型心肌梗死（STEMI）患者的死亡率相关。方法连续选取309例进行PCI的STEMI患者入组,将GNRI评分进行受试者工作特征曲线（ROC）分析,将GNRI≥94或〈94的患者分别被分配为0或1的GNRI评分组。结果在309例STEMI患者中,24例（7.74%）在医院死亡,15例（4.83%）在长期随访期间死亡[中位随访时间为19.5（3~36）月]。与GNRI 0组患者相比,GNRI 1组患者有更显著的在院死亡率（16.7%比4.4%,P〈0.001）和长期随访死亡率（23.8%比8.4%,P〈0.001）。GNRI（HR 2.039,95%CI 1.038~4.004,P=0.039）是接受PCI的STEMI患者死亡率的显著独立预测因子。此外,与GNRI 0组患者相比,GNRI 1组患者的累积生存率显著降低（76.2%比91.6%,log-rank P〈0.001）。结论 GNRI对于接受PCI的STEMI患者风险分层可能是有效的。Aim Investigate whether the Geriatric Nutritional Risk Index（GNRI）,a combined nutritional score based on serum albumin levels and the body mass index（BMI）,was associated with mortality in patients with acute STsegment elevation myocardial infarction（STEMI） undergoing percutaneous coronary intervention（PCI）. Methods309 consecutive patients with STEMI undergoing PCI were prospectively enrolled. Results Patients were then divided into two groups according to GNRI ROC： GNRI≥94 or GNRI94 were assigned a GNRI score of 0 or 1,respectively. Of the 309 STEMI patients,24（7.74%） died in the hospital,and 15（4.83%） died during long-term follow-up（median follow-up time,19.5（3 ~ 36） months）. Compared with patients with a GNRI of 0,patients with a GNRI of 1 had significantly higher in-hospital（16.7% vs 4.4%; P〈0.001） and long-term follow-up（23.8% vs 8.4%,P〈0.001） mortality rates.GNRI（HR 2.039,95%CI 1.038 to 4.004,P = 0.039） was a significant independent predictor of mortality in patients with STEMI undergoing PCI. Moreover,cumulative survival was significantly lower for patients with a GNRI of 1 compared with patients with a GNRI of 0（76.2% vs 91.6%,log-rank P〈0.001）. Conclusion GNRI appears useful for the risk stratification of STEMI patients undergoing PCI.

关 键 词：经皮冠状动脉介入治疗 ST段抬高型心肌梗死 老年人营养风险指数 

分 类 号：R5[医药卫生—内科学]