SII和MHR对Stanford B型主动脉夹层患者TEVAR术后发生院内MACE的预测价值  

Predictive Value of SII and MHR for In-hospital Major Adverse Cardiovascular Events after TEVAR in Stanford Type B Aortic Dissection

作　　者：文海越 徐建辉 WEN Hai-yue;XU Jian-hui(Department of Cardiology,Xiaogan Central Hospital Affiliated to Wuhan University of Science and Technology,Xiaogan 432003,China;Wuhan University of Science and Technology,Wuhan 430062,China)

机构地区：[1]武汉科技大学附属孝感市中心医院心血管内科,孝感432003 [2]武汉科技大学医学院,武汉430062

出　　处：《微循环学杂志》2024年第3期23-29,共7页Chinese Journal of Microcirculation

基　　金：孝感市自然科学计划项目(XGKJ2020010029)。

摘　　要：目的:探讨全身免疫炎症指数(SII)和单核细胞/高密度脂蛋白胆固醇比值(MHR)对Stanford B型主动脉夹层(TBAD)胸主动脉血管修复术(TEVAR术)后发生院内主要不良心血管事件(MACE)的预测价值。方法:回顾性分析2019-06-2023-06于孝感市中心医院接受TEVAR术治疗的145例TBAD患者的临床资料。根据患者院内MACE发生情况,将患者分成MACE组(n=30)和非MACE组(n=115)。比较两组患者的临床资料,采用Logistic回归分析TBAD患者TEVAR术后发生院内MACE的危险因素,采用ROC曲线评估SII和MHR对TBAD患者TEVAR术后发生院内MACE的预测价值。结果:与非MACE组相比,MACE组入院白细胞计数、MHR、SII、TC/HDL升高,高密度脂蛋白胆固醇(HDL-C)降低,年龄较小(P<0.05);多因素Logistic回归分析结果显示,较高水平的SII和MHR是TBAD患者TEVAR术后发生院内MACE的危险因素(P<0.05)。ROC曲线分析结果显示,SII和MHR均对TBAD患者TEVAR术后发生院内MACE具有预测价值(P<0.05),SII灵敏度为43.3%,特异度为84.3%,AUC为0.669(95%CI 0.558-0.780,P<0.05);MHR灵敏度为76.7%,特异度为57.4%,AUC为0.703(95%CI 0.640-0.797,P<0.05);两者联合预测时灵敏度、特异度分别为83.3%、61.7%,AUC为0.766(95%CI 0.682-0.849,P<0.01),联合检测预测价值更高。结论:SII、MHR对TBAD患者TEVAR术后院内MACE的发生具有预测价值,且两者联合预测价值更高。Objective:To explore the predictive value of systemic immune inflammation index(SII)and monocyte count to high-density lipoprotein cholesterol ratio(MHR)for predicting in-hospital major adverse cardiovascular events(MACE)after thoracic endovascular aortic repair(TEVAR)in Stanford B type aortic dissection.Method:A retrospective analysis of clinical data from 145 patients with Stanford B type aortic dissection who underwent TEVAR treatment from June 2019 to June 2023 was conducted.Based on the occurrence of in-hospital MACE,the patients were divided into MACE group(n=30)and non-MACE group(n=115).The clinical data of the two groups was compared,and logistic regression analysis was used to evaluate the risk factors for in-hospital MACE after TEVAR in patients with Stanford B type aortic dissection.The predictive value of SII and MHR for in-hospital MACE after TEVAR in patients with Stanford B type aortic dissection was evaluated using ROC curve analysis.Results:Compared with the non-MACE group,the MACE group had higher levels of white blood cell count,MHR,SII,TC/HDL,and lower levels of HDL,as well as younger age(P<0.05).Multivariate logistic regression analysis showed that higher SII and MHR were risk factors for the occurrence of in-hospital MACE after TEVAR in patients with Stanford B type aortic dissection(P<0.05).ROC curve analysis showed that both SII and MHR could effectively predict the occurrence of in-hospital MACE after TEVAR in patients with Stanford(P<0.05).The sensitivity,specificity,and AUC were 43.3%,84.3%,and 0.669(95%CI 0.558-0.780,P<0.05)for SII,and 76.7%,57.4%,and 0.703(95%CI 0.640-0.797,P<0.05)for MHR,respectively.When combined for prediction,the sensitivity,specificity,and AUC were 83.3%,61.7%,and 0.766(95%CI 0.682-0.849,P<0.01),which were superior to the predictive value of any single index for in-hospital MACE after TEVAR in patients with Stanford B type aortic dissection.Conclusion:SII and MHR have predictive value for the occurrence of in-hospital MACE after TEVAR in patients with Stanford B

关 键 词：Stanford B型主动脉夹层 全身免疫炎症指数 单核细胞计数与高密度脂蛋白胆固醇比 主要不良心血管事件 风险预测 胸主动脉血管修复术 

分 类 号：R543.1[医药卫生—心血管疾病]