GRACE评分联合白细胞血糖指数对AMI患者PCI术后2年内MACE发生的预测价值  

Predictive value of GRACE score combined with leuko-glycemic index for MACE occurrence in AMI patients within 2 years after PCI

作　　者：陈兵[1] 袁玲 李伟章[1] CHEN Bing;YUAN Ling;LI Weizhang(Department of Cardiology,Affiliated Jiangyin Hospital,Medical College of Southeast University,Jiangyin 214400,CHINA)

机构地区：[1]东南大学医学院附属江阴医院心血管内科,江苏江阴214400

出　　处：《江苏医药》2024年第9期935-938,共4页Jiangsu Medical Journal

基　　金：江阴市卫生健康委员会青年科研项目(Q202205)。

摘　　要：目的 探讨全球急性冠状动脉事件注册(GRACE)评分联合白细胞血糖指数(LGI)对急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后2年内主要不良心血管事件(MACE)发生的预测价值。方法 接受PCI治疗的AMI患者256例,依据术后随访2年结果分为MACE发生组(A组,75例)和MACE未发生组(B组,181例)。比较两组临床和实验室指标,分析AMI患者PCI术后2年内MACE发生的危险因素,绘制ROC曲线评估GRACE评分、LGI单独及二者联合对AMI患者PCI术后2年内MACE发生的预测效能。结果 与B组比较,A组男性比例和左心室射血分数(LVEF)降低,年龄、Killip分级>Ⅰ级比例、GRACE评分、心肌肌钙蛋白I(cTnI)、脑钠肽(BNP)、中性粒细胞与淋巴细胞比值(NLR)及LGI均升高(P<0.05或P<0.01)。GRACE评分、cTnI、BNP、LGI升高和LVEF降低均为AMI患者PCI术后2年内MACE发生的独立危险因素(P<0.01)。GRACE评分联合LGI预测AMI患者PCI术后2年内MACE发生的AUC为0.900,灵敏度为81.3%,特异度为85.1%。结论 GRACE评分、LGI升高均为AMI患者PCI术后2年内MACE发生的独立危险因素,且二者联合具有良好的预测价值。Objective To explore the predictive value of global registry of acute coronary events(GRACE)score combined with leuko-glycemic index(LGI)for major adverse cardiovascular events(MACE)occurrence in acute myocardial infarction(AMI)patients within 2 years after percutaneous coronary intervention(PCI).Methods sAccording to 2-year follow-up,256 patients with AMI undergoing PCI were divided into two groups of A(with MACE,75 cases)and B(without MACE,181 cases).Clinical and laboratory indicators of the two groups were compared,the risk factors for MACE occurrence in AMI patients within 2 years after PCI were analyzed,and ROC curves were dawn to evaluate predictive efficacy of GRACE score,LGI alone and in combination in MACE occurrence in AMI patients within 2 years after PCI.Results Compared with group B,group A had lower male proportion and left ventricular ejection fraction(LVEF)(P<0.05 or P<0.01).The age,proportion of Killip grade>grade I,GRACE score,cardiac troponin I(cTnI),brain natriuretic peptide(BNP),neutrophil to lymphocyte ratio(NLR)and LGI were all increased in group A than those in group B(P<0.05 or P<0.01).Elevated GRACE score,cTnI,BNP and LGI and decreased LVEF were the independent risk factors for MACE occurrence in AMI patients within 2 years after PCI(P<0.01).The AUC for combined use of GRACE score and LGI in predicting MACE occurrence in AMI patients within 2 years after PCI was 0.900,with the sensitivity of 81.3%and specificity of 85.1%.Conclusion Elevated GRACE score and LGI are the independent risk factors for MACE occurrence in AMI patients within 2 years after PCI.Combined use of GRACE score and LGI in predicting MACE occurrence has better predictive value.

关 键 词：急性心肌梗死 主要不良心血管事件 全球急性冠状动脉事件注册 白细胞血糖指数 

分 类 号：R541[医药卫生—心血管疾病]