中性粒细胞百分比/白蛋白联合白细胞/红细胞比容对急性ST段抬高型心肌梗死后心脏破裂的预测价值  

Predictive value of neutrophil percentage to albumin ratio in combination with white blood cell to hematocrit ratio for cardiac rupture after acute ST-segment elevation myocardial infarction

作　　者：戴凯 罗雅菲 李志兵 熊芊卉 熊瑶 宋志芳[1] 熊文俊 熊智平 DAI Kai;LUO Ya-Fei;LI Zhi-Bing(Department of Cardiovascular Medicine,the First Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi,China)

机构地区：[1]南昌大学第一附属医院心内科,江西南昌330006 [2]南昌大学附属人民医院,江西南昌330006

出　　处：《中国老年学杂志》2023年第6期1281-1285,共5页Chinese Journal of Gerontology

基　　金：国家自然科学基金(82000234);江西省自然科学基金(20202BABL206004)。

摘　　要：目的 探究中性粒细胞百分比/白蛋白(NPAR)联合白细胞/红细胞比容(WBCHR)对急性ST段抬高型心肌梗死(STEMI)后发生心脏破裂(CR)的预测价值。方法 回顾性收集STEMI患者,最终筛选纳入CR患者(CR组)126例和非CR患者(非CR组)331例。通过Logistic回归分析研究NPAR、WBCHR及其他因素对STEMI后发生CR风险影响,并绘制受试者工作特征(ROC)曲线评估NPAR、WBCHR及两者联合对CR的预测价值。结果 根据多因素Logistic回归分析结果,年龄(OR=1.04,95%CI:1.00~1.08,P=0.033)、收缩压(OR=0.98,95%CI:0.97~1.00,P=0.032)、红细胞(OR=0.50,95%CI:0.26~0.95,P=0.033)、急诊经皮冠状动脉介入(PCI)(OR=0.36,95%CI:0.18~0.75,P=0.006)、NPAR(OR=2.44,95%CI:1.13~5.30,P=0.024)和WBCHR(OR=1.08,95%CI:1.04~1.12,P<0.001)是CR的独立影响因素。在ROC曲线分析中,NPAR和WBCHR单独预测CR风险的ROC曲线下面积分别为0.81(95%CI:0.76~0.86,P<0.001)、0.83(95%CI:0.78~0.88,P<0.001),两者联合预测的ROC曲线下面积为0.86(95%CI:0.81~0.90,P<0.001)。结论 NPAR和WBCHR联合检测可提高早期预测STEMI后发生CR的准确性,为该疾病的前期预防提供了简便易得的有效预测工具。Objective To explore the clinical value of neutrophil percentage to albumin ratio(NPAR) combined with white blood cell to hematocrit ratio(WBCHR) in predicting cardiac rupture(CR) after acute ST-segment elevation myocardial infarction(STEMI).Methods STEMI patients were collected retrospectively. Finally, 126 patients with CR(CR group)and 331 non-CR patients(non-CR group) were enrolled.The Logistic regression analysis was used to explore the impact of NPAR, WBCHR and other factors to the CR after STEMI, and the receiver operating characteristic(ROC) curve was conducted to evaluate the value of NPAR, WBCHR and combination of the two in predicting CR.Results According to the multivariate Logistic regression analysis, the age(OR=1.04, 95%CI:1.00~1.08, P=0.033), systolic blood pressure(OR=0.98,95%CI:0.97~1.00, P=0.032), red blood cell(OR=0.50, 95%CI:0.26~0.95,P=0.033), emergency percutaneous coronary intervention(PCI)(OR=0.36, 95%CI:0.18~0.75, P=0.006), NPAR(OR=2.44,95% CI:1.13~5.30, P=0.024) and WBCHR(OR=1.08, 95%CI:1.04~1.12, P<0.001) were independent factors for CR. In ROC curve analysis, the area under ROC curve of NPAR and WBCHR were 0.81(95%CI:0.76~0.86,P<0.001) and 0.83(95%CI:0.78~0.88,P<0.001), respectively. The area under ROC curve of the combination of NPAR and WBCHR was 0.86(95%CI:0.81~0.90,P<0.001).Conclusions The combination of NPAR and WBCHR could improve the accuracy of early prediction of the occurrence of CR after STEMI, and provide a simple and effective tool for the early prevention of the disease.

关 键 词：心脏破裂 急性心肌梗死 中性粒细胞百分比/白蛋白 白细胞/红细胞比容 

分 类 号：R54[医药卫生—心血管疾病]