甘油三酯-葡萄糖指数联合中性粒细胞-淋巴细胞比值预测药物洗脱支架治疗非糖尿病急性冠状动脉综合征患者预后的价值  

The prognostic value of TyG index combined with NLR in non-diabetic ACS patients treated with DES

作　　者：左秀秀 魏迎丽 侯天华[2] ZUO Xiu-xiu;WEI Ying-li;HOU Tian-hua(Clinical School of Chengde Medical College,Chengde 067000,China;Department of Cardiovascular Medicine,Chengde Central Hospital,Chengde 067000,China)

机构地区：[1]承德医学院临床学院,河北省承德市067000 [2]承德市中心医院心血管内科

出　　处：《中国心血管病研究》2023年第6期570-576,共7页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨甘油三酯-葡萄糖指数(TyG指数)联合中性粒细胞-淋巴细胞比值(NLR)预测药物洗脱支架(DES)治疗的非糖尿病急性冠状动脉综合征(ACS)患者预后的价值。方法 回顾性纳入2019年10月至2021年10月于承德市中心医院行冠状动脉造影并接受DES治疗的非糖尿病ACS患者,依据纳排标准总计377例患者入组,采集患者一般临床资料、血常规、生化,左心室射血分数(LVEF)、冠状动脉造影检查及介入治疗信息;计算TyG指数、NLR、残余脂蛋白胆固醇(RLP-C)、非高密度脂蛋白胆固醇(non HDL-C)以及Gensini评分。随访患者出院后主要心血管不良事件(MACE)发生情况,依据随访期间是否发生MACE分为MACE组(50例)和非MACE组(327例)。应用SPSS 25.0统计分析,比较组间患者一般临床资料特征及MACE发生情况,绘制Kaplan-Meier曲线。采用Cox比例风险模型分析DES治疗后的非糖尿病ACS患者发生MACE的危险因素。应用受试者工作特征曲线(ROC)曲线评估TyG指数、NLR及二者联合对DES治疗后的非糖尿病ACS患者预后的诊断效能。结果 MACE组患者TyG指数及NLR水平显著高于非MACE组(8.86比8.57,P<0.05),高TyG指数组具有更高的MACE发生率(19.3%比7%,P<0.001)。进一步Cox回归分析显示,调整危险因素后TyG指数(P<0.001,HR=3.345,95%CI 1.894~5.907)及NLR(P<0.001,HR=1.146,95%CI 1.062~1.238)仍是患者发生MACE的独立危险因素,二者联合后预测MACE的诊断效能高于单一指标(AUC:0.798,敏感度70%,特异度80%)。结论 TyG指数及NLR是DES治疗后非糖尿病ACS患者发生MACE的危险因素,二者联合可进一步提高对DES治疗后非糖尿病ACS患者的预测价值。Objective To investigate the prognostic value of triglyceride-glucose index(TyG index)combined with neutrophil-lymphocyte ratio(NLR)in non-diabetic acute coronary syndrome(ACS)patients treated with drug-eluting stents(DES).Methods A total of 377 non-diabetic ACS patients who underwent coronary angiography and underwent DES treatment in Chengde Central Hospital from October 2019 to October 2021 were retrospectively enrolled,according to the inclusion and exclusion criteria.The general clinical data,blood routine,biochemical,left ventricular ejection fraction(LVEF),coronary angiography and interventional therapy information of the patients were collected.TyG index,NLR,residual lipoprotein cholesterol(RLP-C),non-highdensity lipoprotein cholesterol(non HDL-C)and Gensini score were calculated.The patients were followed up for the occurrence of major adverse cardiovascular events(MACE)after discharge.According to the occurrence of MACE during the follow-up period,the patients were divided into MACE group(50 cases)and non-MACE group(327 cases).SPSS 25.0 statistical analysis was used to compare the general clinical data characteristics and the incidence of MACE between the two groups,and Kaplan-Meier curve was drawn.Cox proportional hazards model was used to analyze the risk factors of MACE in non-diabetic ACS patients treated with DES.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of TyG index,NLR and their combination for the prognosis of non-diabetic ACS patients treated with DES.Results The TyG index and NLR in MACE group were significantly higher than those in non-MACE group(8.86 vs.8.57,P<0.05),and the high TyG index group had a higher incidence of MACE(19.3%vs.7%,P<0.001).Further Cox regression analysis showed that TyG index(P<0.001,HR=3.345,95%CI 1.894-5.907)and NLR(P<0.001,HR=1.146,95%CI 1.062-1.238)were still the independent risk factors for MACE in the patients.The diagnostic efficacy of the combination of the two indexes for predicting MACE was higher than that of

关 键 词：急性冠状动脉综合征 甘油三酯-葡萄糖指数 中性粒细胞-淋巴细胞比值 预后 

分 类 号：R541.4[医药卫生—心血管疾病]