心肌甘油三酯含量与HEART评分对急诊ACS患者早期院内MACE的预警价值  

Predictive value of myocardial triglyceride content and HEART score for early in-hospital MACE in emergency patients with acute coronary syndrome(ACS)

作　　者：刘青青 曹洪丽[1] 王明虎 LIU Qingqing;CAO Hongli;WANG Minghu(Emergency Medical Center of Beijing Rehabilitation Hospital Affiliated to Capital Medical University,Beijing 100144,China)

机构地区：[1]首都医科大学附属北京康复医院急救医学中心,北京100144

出　　处：《新疆医科大学学报》2023年第3期333-337,共5页Journal of Xinjiang Medical University

基　　金：北京市科技计划项目(Z1511)。

摘　　要：目的 探讨心肌甘油三酯(Triglyceride, TG)含量与HEART评分对急诊急性冠脉综合征(Acute coronary syndeome, ACS)患者早期院内主要心血管不良事件(Major adverse cardiovascular events, MACE)的预警价值。方法 300例ACS患者于经皮冠状动脉介入(Percutaneous coronary intervention, PCI)治疗前进行室间隔氢质子磁共振波谱(1H-MRS)检查,测定心肌甘油三酯(Triglyceride, TG)含量,并进行HEART评分。根据是否发生院内MACE分为发生组和未发生组,分析心肌TG含量和HEART评分对早期院内MACE发生情况的预警价值。结果 纳入病例中院内MACE者37例,发生率12.33%。发生组的平均年龄、心率(Heart rate, HR)、肌钙蛋白1(Cardiac troponin 1,cTn1)、D-二聚体(D dimer, D-D)、肌红蛋白(Myoglobin, Myo)、心肌TG水平、HEART评分、总胆固醇(Total cholesterol, TC)及TG水平均高于未发生组,钠离子(NA+)水平低于未发生组(P<0.05)。经多因素Logistic回归分析筛选院内MACE发生的独立预测因子为cTn1、D-D、心肌TG、HEART评分(P<0.05)。受试者工作特征曲线(Receiver operating characteristic,ROC)分析结果显示,心肌TG和HEART评分分别以0.77%和7分为Cut-off值,预警急诊ACS患者早期院内MACE的ROC曲线下面积(Area under curve,AUC)分别为0.895和0.906,二者联合的AUC为0.981,联合使用AUC更高(P<0.05)。结论 心肌TG含量和HEART评分可作为急诊ACS患者早期院内MACE发生的独立预测因子,且联合应用具有更高的预警价值,可作为急诊ACS患者治疗决策制定的参考指标。Objective To investigate the predictive value of myocardial triglyceride(TG)content and HEART score in early in-hospital major adverse cardiovascular events(MACE)of emergency patients with acute coronary syndrome(ACS).Methods A total of 300 ACS underwent ventricular septal 1H-magnetic resonance spectroscopy(1H-MRS)examination before percutaneous coronary intervention(PCI).Myocardial TG content was determined,and HEART score was performed.According to the occurrence of MACE in hospital,the patients were divided into occurrence group and non-occurrence group.To analyze the value of myocardial TG content and HEART score in early warning of the occurrence of MACE in hospital.Results 37 patients with MACE in hospital were included with an incidence of 12.33%.The mean age,heart rate(HR),cardiac troponin 1(cTn1),D-dimer(D-D),myoglobin(Myo),myocardial TG content,HEART score,total cholesterol(TC)and TG in the occurrence group were higher than those in the non-incidence group,and the sodium ion(NA+)level was lower than that of non-occurrence group(P<0.05).Independent predictors of in-hospital MACE occurrence screened by multifactorial Logistic regression analysis were cTn1,D-D,myocardial TG and HEART score(P<0.05).The results of ROC analysis showed that myocardial TG and HEART scores were divided into cut-off values of 0.77%and 7 points,respectively,and the AUC of early warning of in-hospital MACE with emergency ACS was 0.895 and 0.906,respectively.The combined AUC of the two was 0.981,and the combined AUC was higher(P<0.05).Conclusion Myocardial TG content and HEART score can be used as the independent predictors of early in-hospital MACE in patients with emergency ACS,and the combined application has higher early warning value,and it can be used as the reference indicators for treatment decision-making in patients with emergency ACS.

关 键 词：甘油三酯 急性冠脉综合征 HEART评分 主要不良心血管事件 

分 类 号：R541[医药卫生—心血管疾病]