IL-16联合GRACE出院评分对老年非ST段抬高型急性冠状动脉综合征病人不良心脑血管事件的预测价值  

Predictive value of IL-16 combined with GRACE discharge score for adverse cardiovascular and cerebrovascular events in elderly patients with non-ST elevation acute coronary syndrome

作　　者：季鹏 孙伟[2] 贾玉卿 JI Peng;SUN Wei;JIA Yu-qing(Department of Cardiology,Liaoyang Central Hospital,Liaoyang 111000,China;Department of Cardiology,Dalian Third People’s Hospital,Dalian 116000,China;Department of Cardiology,Heze Municipal Hospital,Heze 274600,China)

机构地区：[1]辽阳市中心医院心内一科,辽宁省辽阳市111000 [2]大连市第三人民医院心内科,辽宁省大连市116000 [3]菏泽市立医院心内三科,山东省菏泽市274600

出　　处：《实用老年医学》2021年第9期939-942,947,共5页Practical Geriatrics

摘　　要：目的探讨IL-16联合全球急性冠状动脉事件注册研究(GRACE)出院评分对老年非ST段抬高型急性冠状动脉综合征(NSTE-ACS)病人主要不良心脑血管事件(MACCE)的预测价值。方法选取2017年1月至2018年8月期间在我院接受治疗的老年NSTE-ACS病人182例,所有病人均随访12个月,根据是否发生MACCE分为MACCE组(n=38)和无MACCE组(n=144)。比较2组一般资料、心功能指标、IL-16水平及GRACE出院评分。采用多因素Logistic回归分析老年NSTE-ACS病人发生MACCE的危险因素,ROC曲线分析指标预测MACCE的价值。结果MACCE组的年龄、N端脑钠肽前体(NT-proBNP)、IL-16水平及GRACE出院评分均高于无MACCE组,LVEF低于无MACCE组,差异均有统计学意义(P<0.01)。多因素Logistic回归分析显示,除LVEF是保护因素之外,年龄、NT-proBNP、IL-16、GRACE出院评分均为老年NSTE-ACS病人发生MACCE的危险因素(P<0.05)。ROC曲线分析显示,IL-16的AUC为0.727(95%CI0.640~0.814),GRACE出院评分的AUC为0.781(95%CI0.706~0.857),两者联合检测的敏感度和约登指数较单一检测均有所提升。结论IL-16联合GRACE出院评分对老年NSTE-ACS病人发生MACCE有较高的预测价值。Objective To explore the predictive value of interleukin-16(IL-16)combined with global registry of acute coronary events(GRACE)discharge score for major adverse cardiovascular and cerebrovascular events(MACCE)in the elderly patients with non-ST elevation acute coronary syndrome(NSTE-ACS).Methods A total of 182 elderly NSTE-ACS patients who were treated in our hospital from January 2017 to August 2018 were selected.All the patients were followed up for 12 months.According to whether MACCE occurred,the patients were divided into MACCE group(n=38)and non-MACCE group(n=144).The general data and the levels of cardiac function indexes,IL-16 and the GRACE discharge score were observed and compared between the two groups.The risk factors of MACCE were analyzed by multivariate Logistic regression analysis.The predictive value of IL-6 and GRACE score for MACCE in the elderly patients with NSTE-ACS was analyzed by receiver operating characteristic(ROC)curve analysis.Results The age and the levels of N-terminal pro-brain natriuretic peptide(NT-proBNP),IL-16 and GRACE discharge score in MACCE group were significantly higher and the left ventricular ejection fraction(LVEF)was significantly lower than that in non-MACCE group(P<0.01).Multivariate Logistic regression analysis showed that LVEF was a protective factor,while age,NT-proBNP,IL-16 and GRACE discharge score were risk factors of MACCE in the elderly NSTE-ACS patients(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of IL-16 was 0.727(95%CI 0.640-0.814),the AUC of GRACE discharge score was 0.781(95%CI 0.706-0.857),and the sensitivity and Yoden index of combined test were improved.Conclusions IL-16 combined with GRACE discharge score have a high predictive value for the occurrence of MACCE in the elderly NSTE-ACS patients.

关 键 词：非ST段抬高型急性冠状动脉综合征 白细胞介素-16 全球急性冠状动脉事件注册研究出院评分 不良心脑血管事件 预测价值 

分 类 号：R541.4[医药卫生—心血管疾病]