两项炎性指标联合对老年急性心肌梗死患者术后院内不良预后的预测价值  

Value of combined 2 inflammatory indicators for poor prognosis during hospitalization in elderly with AMI after emergency PCI

作　　者：王家琦 王禹丹 吴路路 张飞飞[2] 宋学莲 李英肖[2] 党懿[2] 齐晓勇[2] Wang Jiaqi;Wang Yudan;Wu Lulu;Zhang Feifei;Song Xuelian;Li Yingxiao;Dang Yi;Qi Xiaoyong(Graduate School of Hebei North University,Zhangjiakou 075000,Hebei Province,China)

机构地区：[1]河北北方学院研究生院,张家口075000 [2]河北省人民医院心血管内科

出　　处：《中华老年心脑血管病杂志》2022年第8期807-810,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：河北省自然科学基金(H2020307017);河北省2019年度医学科学研究课题(20190237)。

摘　　要：目的探讨单核细胞计数/高密度脂蛋白比值(MHR)及全身免疫炎症指数(SII)对老年急性ST段抬高型心肌梗死(STEMI)患者急诊PCI术后院内不良预后的预测价值。方法选取2017年1月1日~2020年6月30日就诊于河北省人民医院心血管内科接受急诊PCI的老年急性STEMI患者578例,根据患者PCI术后是否发生院内主要不良心血管事件(MACE)分为MACE组76例和非MACE组502例。收集患者临床相关资料,用ROC曲线评估MHR、SII及联合因子对老年STEMI患者院内MACE的预测价值。结果MACE组SII及MHR水平明显高于非MACE组(P<0.01)。SII、MHR是老年急性STEMI患者PCI术后发生院内MACE事件的独立影响因素(P<0.01)。ROC曲线分析显示,SII和MHR预测院内MACE的曲线下面积(AUC)分别为0.729(95%CI:0.672~0.786,P<0.01)和0.720(95%CI:0.668~0.772,P<0.01),二者联合预测的AUC更高,为0.797(95%CI:0.746~0.847,P<0.01)。结论SII、MHR是老年急性STEMI患者PCI术后院内MACE的独立危险因素,两者联合对老年急性STEMI患者PCI术后院内MACE具有较好的预测价值。Objective To investigate the predictive value of monocyte to HDL-C ratio(MHR)and SII for short-term adverse prognosis in the elderly patietns with STEMI after emergency PCI.Methods A total of 578 elderly patients with acute STEMI who received emergency PCI in the Department of Cardiovascular Medicine of Hebei General Hospital from January 2017 to June 2020 were recruited in this study.According to whether MACE occurred after PCI,they were di-vided into MACE group(n=76)and non-MACE group(n=502).Their clinical data were collect-ed.ROC curve was drawn to test the predictive values of MHR,SII and their combination for MACE during hospitalization.Results The MACE group had significantly higher SII and MHR than the non-MACE group(P<0.01).SII and MHR were independent influencing factors for MACE after PCI in the elderly patients with acute STEMI(P<0.01).ROC curve analysis indica-ted that the area under curve(AUC)of MACE predicted by SII and MHR were 0.729(95%CI:0.672-0.786,P<0.01)and 0.720(95%CI:0.668-0.772,P<0.01),and the area of their combination was 0.797(95%CI:0.746-0.847,P<0.01).Conclusion SII and MHR are inde-pendent predictors of MACE in elderly STEMI patients after PCI,and their combination shows good predictive value for MACE during hospitalization.

关 键 词：心肌梗死 单核细胞 脂蛋白类 HDL 预后 

分 类 号：R542.22[医药卫生—心血管疾病]