动脉血乳酸/血清白蛋白比值对冠状动脉旁路移植术患者术后3 a内发生主要不良心血管事件的预测价值  

Predictive value of arterial lactate/albumin ratio for 3-year major adverse cardiovascular events in patients after coronary artery bypass grafting

作　　者：王静[1] 郝爽 张竞超[1] 裴宇[1] 徐敬[1] WANG Jing;HAO Shuang;ZHANG Jingchao;PEI Yu;XU Jing(Department of Cardiovascular Surgery,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院心血管外科,郑州450052

出　　处：《郑州大学学报（医学版）》2023年第5期639-643,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金项目(81800319)。

摘　　要：目的:探讨动脉血乳酸/血清白蛋白比值(LAR)对冠状动脉旁路移植术(CABG)患者术后3 a内发生主要不良心血管事件(MACE)的预测价值。方法:回顾性分析2018年1至5月在郑州大学第一附属医院接受CABG的358例患者的临床资料,随访3 a。根据术后LAR分为低比值组(137例)、中比值组(112例)和高比值组(109例),比较3组的MACE发生率。采用Logistic回归分析筛选术后3 a内发生MACE的危险因素。采用ROC曲线评估LAR或LAR联合其他危险因素对术后3 a内发生MACE的预测价值。结果:从低比值组到高比值组,MACE发生率升高,高比值组MACE发生率为23.9%。Logistic回归分析结果显示,BMI(OR=1.193,95%CI 1.068~1.333)、LAR(OR=3.029,95%CI 0.973~9.428)和糖尿病(OR=2.559,95%CI 1.193~5.487)是发生MACE的危险因素。ROC曲线显示,LAR预测MACE的曲线下面积为0.703(95%CI 0.656~0.745),敏感度为0.692,特异度为0.614;LAR联合糖尿病、BMI预测MACE的曲线下面积为0.743(95%CI 0.664~0.799),敏感度为0.762,特异度为0.661。结论:LAR是CABG患者术后3 a内发生MACE的危险因素,可联合糖尿病、BMI预测患者不良预后。Aim:To investigate the predictive value of arterial lactate/albumin ratio(LAR)for major adverse cardiovascular events(MACE)within 3 years in patients after coronary artery bypass grafting(CABG).Methods:A retrospective analysis was performed on 358 patients who underwent CABG in the Department of Cardiovascular Surgery of the First Affiliated Hospital of Zhengzhou University from January 2018 to May 2018,and the follow-up time was 3 years.According to LAR after CABG,they were allocated into 3 groups,low LAR group(137 cases),medium LAR group(112 cases)and high LAR group(109 cases).The incidence of MACE among 3 groups were compared.Logistic regression analysis was used to screen the risk factors of MACE.ROC curve was used to evaluate the value of LAR or LAR combined with other screened indexes in predicting MACE.Results:The incidence of MACE gradually increased from low LAR group to high LAR group,and the incidence of high LAR group was 23.9%(P<0.05).Logistic regression analysis showed that BMI(OR=1.193,95%CI 1.068-1.333),LAR(OR=3.029,95%CI 0.973-9.428)and diabetes(OR=2.559,95%CI 1.193-5.487)were risk factors of MACE.ROC curve showed that AUC(95%CI)of LAR predicting MACE was 0.703(0.656-0.745),with a sensitivity of 0.692,a specificity of 0.614,and AUC(95%CI)of LAR combined with diabetes and BMI predicting MACE was 0.743(0.664~0.799),with a sensitivity of 0.762,a specificity of 0.661.Conclusion:LAR is a risk factor of the occurrence of MACE within 3 years in patients after CABG,and can be combined with diabetes and BMI to predict poor prognosis.

关 键 词：动脉血乳酸/血清白蛋白比值 冠状动脉旁路移植术 不良心血管事件 

分 类 号：R619[医药卫生—外科学]