血浆高敏C反应蛋白与白蛋白比值对急性心肌梗死患者高Killip等级预测分析  

Predictive value of plasma high-sensitivity C-reactive protein/albumin for high Killip class in patients with acute myocardial infarction

作　　者：张宁[1] 陈立颖[1] 康云鹏[1] ZHANG Ning;CHEN Liying;KANG Yunpeng(Department of Cardiology Cardiac Intensive Care Unit,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所、心内重症医学中心,100029

出　　处：《心肺血管病杂志》2023年第3期221-226,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：北京市医管局市属医院科研培育计划项目(PX2018026)。

摘　　要：目的:探讨急性心肌梗死(AMI)患者血浆高敏C反应蛋白/白蛋白比值(hsCRP/ALB)对高Killip等级预测分析。方法:入选2020年8月至2022年8月在我院住院的急性心肌梗死患者共745例。根据心功能分级将患者分为心功能Killip I-IV级共四组。入院后测定血浆高敏C反应蛋白(hs-CRP)及白蛋白浓度(ALB),计算比值。分析四组间基线资料及hs-CRP/ALB比值有无差异。将心功能Ⅲ-Ⅳ级定义为高Killip等级组,利用受试者工作特征曲线(ROC)分析各变量预测高Killip等级的受试者工作特征曲线下面积(AUC)。利用Logistic回归分析各变量预测高Killip等级的比值比(OR值)。结果:心功能四组间hs-CRP/ALB差异有统计学意义(P <0.05);BNP、hs-CRP、hs-CRP/ALB预测高Killip等级的ROC曲线下面积分别为0.764(95%CI:0.709~0.819,P=0.000),0.780(95%CI:0.729~0.831,P=0.000),0.803(95%CI:0.738~0.869,P=0.000)。Logistic回归分析提示随着hs-CRP/ALB比值升高,患者为高Killip等级相应的OR=2.862(95%CI:1.099~7.456,P=0.000)。结论:急性心肌梗死患者心功能Killip分级越高,hs-CRP/白蛋白比值越高;hs-CRP/ALB比值是急性心肌梗死患者高Killip等级的独立危险因素;hs-CRP/ALB比值可以作为预测急性心肌梗死患者高Killip等级一个有效指标。Objective:To investigate the predictive value of plasma high-sensitivity C-reactive protein/albumin(hs-CRP/ALB)for high Killip class in patients with acute myocardial infarction(AMI).Methods:The present study enrolled 745 patients with AMI from August 2020 to August 2022.Patients were divided into four groups based on Killip class.After admission,the plasma hs-CRP and albumin concentrations were measured and the ratio was calculated.The baseline data and hs-CRP/ALB ratio between the four groups were analyzed for statistical differences.Class III-IV of cardiac function is defined as a high Killip class,The receiver Operating characteristic curve(ROC)was used to analyze each variable to predict the area under the ROC Curve(AUC)of high Killip class.Logistic regression analysis was used to predict the odds ratio(OR)of high Killip class.Results:There was significant difference in hs-CRP/ALB among the four groups(P<0.05);The area under the ROC curve(AUC)of BNP,hs-CRP and hs-CRP/ALB for predicting high Killip class were 0.764(95%CI:0.709-0.819,P=0.000)0.780,95%CI:0.729-0.831,P=0.000;0.803,95%CI:0.738-0.869,P=0.000.Logistic regression analysis showed that with the increase of hs-CRP/ALB ratio,the corresponding OR of patients with high Killip class was 2.862(95%CI:1.099-7.456,P=0.000).Conclusions:The higher Killip class in patients with acute myocardial infarction was,the higher hs-CRP/albumin ratio was.hs-CRP/ALB ratio was an independent risk factor for high Killip class in patients with AMI.The hs-CRP/ALB ratio can be used as an effective indicator to predict high Killip class in patients with AMI.

关 键 词：急性心肌梗死 高敏C反应蛋白/白蛋白比值 心功能Killip分级 

分 类 号：R54[医药卫生—心血管疾病]