尿酸白蛋白比值对冠状动脉慢性完全闭塞患者中远期全因死亡的预测价值  

The predictive value of uric acid to albumin ratio for medium and long-term all-cause mortality in patients with CTO

作　　者：张晶晶[1] 赵宇飞 朱华良 祝小霞[1] 刘泽岩[2] 黄正 ZHANG Jingjing;ZHAO Yufei;ZHU Hualiang;ZHU Xiaoxia;LIU Zeyan;HUANG Zheng(Cardiovascular Department for Gerontism,the Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230011,China;不详)

机构地区：[1]安徽医科大学第二附属医院老年心血管内科,安徽合肥230011 [2]安徽医科大学第二附属医院急诊内科 [3]安徽医科大学第二附属医院心血管内科

出　　处：《中华全科医学》2024年第9期1496-1499,共4页Chinese Journal of General Practice

基　　金：安徽省高等学校自然科学研究重点项目(2022AH050770)。

摘　　要：目的探讨尿酸白蛋白比值(UAR)能够反映机体的炎症和氧化状态,分析其在冠状动脉慢性闭塞(CTO)患者中的表达水平,并评估其对患者中远期死亡的预判价值。方法选取2019年1月—2023年3月安徽医科大学第二附属医院行冠脉造影的CTO患者259例,根据患者的预后情况将其分为存活组和死亡组,入院行冠脉造影前计算UAR。应用单因素回归分析和多因素logistic回归分析评估UAR对CTO患者死亡不良事件的影响。结果本研究随访期[(39.9±12.3)个月]内,259例CTO患者中有39例(15.06%)死亡,220例(84.94%)存活。与存活组比较,死亡组患者的年龄更大,CTO双支病变比例更高,尿素氮、肌酐、尿酸、UAR及中性粒细胞-淋巴细胞比值(NLR)水平更高,完全血运重建例数更少,白蛋白及甘油三酯水平更低,差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,CTO患者预后不良的危险因素包括年龄增长、CTO病变数量增多及UAR增高。UAR预测CTO患者中远期全因死亡的ROC曲线下面积为0.648(95%CI:0.547~0.748,P=0.003),灵敏度为53.8%,特异度为72.7%。结论与生存者相比,死亡的CTO患者UAR明显增高,UAR对冠状动脉慢性完全闭塞患者中远期全因死亡具有一定的预测价值。ObjectiveUric acid to albumin ratio(UAR)can reflect the inflammation and oxidation status,this study was to analyze its expression level in patients with chronic coronary artery occlusion(coronary chronic total occlusion,CTO),and evaluate its prediction value for long-term death in patients.MethodsA total of 259 CTO patients undergoing coronary angiography in the Second Affiliated Hospital of Anhui Medical University from January 2019 to March 2023 were selected,and the patients were divided into survival group and death group according to their prognosis.Univariate regression analysis and multivariate logistic regression analysis were used to evaluate the effect of UAR on mortality adverse events in CTO patients.ResultsAmong the 259 CTO patients,39(15.06%)died and 220(84.94%)survived during the follow-up period of approximately of(39.9±12.3)months.Compared with the survival group,patients in the death group exhibited a older age,higher proportion of dual-vessel lesions of CTO,higher levels of blood urea nitrogen,creatinine,uric acid,UAR,and neutrophil-to-lymphocyte ratio(NLR),fewer cases of complete revascularization,and lower levels of albumin and triglycerides(P<0.05).Multivariate logistic regression analysis showed that the risk factors for poor prognosis in CTO patients include increasing age,increased number of CTO lesions and elevated UAR.The area under the ROC curve for UAR predicting mid to long-term all-cause mortality in CTO patients was 0.648(95%CI:0.547-0.748,P=0.003),with a sensitivity of 53.8%and a specificity of 72.7%.ConclusionThe UAR of the deceased is significantly higher compared to survivors,indicating that UAR holds certain predictive value for mid to long-term all-cause mortality in patients with chronic total occlusion of the coronary arteries.

关 键 词：尿酸白蛋白比值 冠状动脉慢性完全闭塞 回归分析 

分 类 号：R543.31[医药卫生—心血管疾病]