碱性磷酸酶与白蛋白比值对急性冠脉综合征患者介入治疗预后的影响  

Effect of alkaline phosphatase-to-albumin ratio in predicting prognosis of patient with acute coronary syndrome after percutaneous coronary intervention.

作　　者：温宗玉 焦云娣[1] 武佳科 宋佳[1] 何东旭[1] 段伟丽 孙娜[1] 于彤彤[1] 孙志军[1] 孙兆青[1] WEN Zong-yu;JIAO Yun-di;WU Jia-ke;SONG Jia;HE Dong-xu;DUAN Wei-li;SUN Na;YU Tong-tong;SUN Zhi-jun;SUN Zhao-qing(Department of Cardiology,Shengjing Hospital Affiliated to China Medical University,Shenyang 110022,China)

机构地区：[1]中国医科大学附属盛京医院心血管内科,辽宁沈阳110022

出　　处：《中国实用内科杂志》2021年第2期136-140,共5页Chinese Journal of Practical Internal Medicine

基　　金：辽宁省科技厅社会发展攻关计划(2011225020)。

摘　　要：目的评估碱性磷酸酶(ALP)与白蛋白(ALB)比值(APAR)对急性冠脉综合征(ACS)患者预后的影响。方法按前瞻队列研究连续入选2015年1月至2016年12月就诊于中国医科大学附属盛京医院确诊为ACS并择期进行经皮冠状动脉支架植入术(PCI)治疗的患者共2162例。根据入院次日APAR分成两组,收集所有患者临床资料、冠脉病变情况、术后用药以及随访1年记录临床终点事件。通过COX回归分析研究APAR水平对于ACS患者预后的影响。结果根据COX单因素分析,APAR值与ACS全因死亡率[HR(95%CI)2.432(1.475,4.010),P<0.001]和心源性死亡率[HR(95%CI)2.884(1.627,5.111),P<0.001]相关,多因素分析调整变量后,APAR值与ACS全因死亡率[HR(95%CI)1.839(1.059,3.192),P=0.03]及心源性死亡率[HR(95%CI)2.232(1.170,4.258),P=0.01]仍相关。APAR值与ACS患者临床预后的关系比ALP、ALB单独变量更为密切(曲线下面积:0.635、0.592、0.397)。结论APAR水平较高患者长期的全因死亡率及心源性死亡率更高,APAR可以作为预测ACS患者预后的独立危险因素。Objective To determine the effect of alkaline phosphatase-to-albumin ratio(APAR)on the prognosis of patients with acute coronary syndrome(ACS). Methods By prospective cohort study,a total of 2162 patients with ACS diagnosed in Shengjing Hospital of China Medical University from January 2015 to December 2016 were enrolled for the study. All patients underwent selective percutaneous coronary artery intervention. Then the patients were divided into two groups according to the APAR on the day after admission;collect all patients’ clinical data,the severity of coronary lesion,postoperative medication,and record the clinical endpoint events at 1 year follow-up. The effect of APAR on the prognosis was studied by the COX regression analysis. Results COX analysis shows that APAR values were associated with allcause mortality[HR(95%CI)2.432(1.475,4.010),P<0.001]and cardiogenic mortality[HR(95%CI)2.884(1.627,5.111),P<0.001]. Multivariate analysis adjusted for variables shows it was also associated with them[HR(95%CI)1.839(1.059,3.192),P=0.03],[HR(95%CI)2.232(1.170,4.258),P=0.01]. APAR is more stronger predictor of prognosis than ALP,ALB(area under curve:0.635,0.592,0.397). Conclusions Patients with high APAR had higher long-term all-cause mortality and cardiac mortality,so APAR can be considered as a predictor of prognosis on patients with ACS.

关 键 词：急性冠脉综合征 碱性磷酸酶 白蛋白 冠脉介入治疗 预后 

分 类 号：R541.4[医药卫生—心血管疾病]