清蛋白校正阴离子间隙评估急性心肌梗死病人预后的价值  

Predictive Value of Albumin Corrected Anion Gap in Prognosis of Patients with Acute Myocardial Infarction

作　　者：倪伟智 邵紫欣 袁丁[2] NI Weizhi;SHAO Zixin;YUAN Ding(Guangzhou University of Chinese medicine,Guangzhou 510000,Guangdong,China;Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou 510095,Guangdong,China)

机构地区：[1]广州中医药大学,广州510000 [2]广东省第二中医院,广州510095

出　　处：《中西医结合心脑血管病杂志》2024年第20期3754-3758,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的:探讨清蛋白校正阴离子间隙(ACAG)对急性心肌梗死(AMI)病人预后的预测价值,为ACAG用于该人群的危险分层提供依据。方法:从重症监护医学信息数据库(MIMIC-Ⅳ)中提取符合标准的AMI病人的临床资料,以病人30 d全因死亡为主要结局指标。所有病人依据ACAG数值以三分位间距分成3组,使用Kaplan-Meier法构建生存曲线,并使用Cox风险比例回归模型探索ACAG与主要结局指标的关系,利用多因素回归分析校正混杂因素。运用受试者工作特征(ROC)曲线下面积(AUC)评估ACAG对AMI病人的预测价值。结果:共入组1838例AMI病人,构建生存曲线后发现3组不同ACAG病人的生存率差异有统计学意义(P<0.001)。使用Cox风险比例回归模型进行多因素分析后发现,无论作为定量还是分组变量,ACAG升高对生存结局的影响都具有统计学意义(均P<0.001)。ROC曲线显示,相比于阴离子间隙(AG)和清蛋白,ACAG对30 d死亡的预测价值更高,差异均有统计学意义(均P<0.001)。结论:ACAG升高是AMI病人30 d全因死亡的独立危险因素。Objective:To investigate the predictive value of albumin corrected anion gap(ACAG)in prognosis of patients with acute myocardial infarction(AMI),and to provide evidence for the application of ACAG in risk stratification of these patients.Methods:The clinical data of AMI patients were extracted from Medical Information Mart for Intensive Care(MIMIC-Ⅳ),and the 30-day all-cause death was taken as the primary outcome.All patients were divided into three groups according to the ACAG value.Kaplan-Meier method was used to construct the survival curve,and then Cox risk proportional regression model was used to explore the relationship between ACAG and main outcome indicators while adjusting for confounding factors through multivariate regression analysis.In addition,the area under the curve(AUC)of receiver operating characteristic curve(ROC)was used to evaluate the predictive value of ACAG for AMI patients.Results:A total of 1838 AMI patients were collected.After constructing the survival curve,it was found that there was a significant difference in the survival rate among the three groups(P<0.001).After multivariate correction by Cox proportional regression model,the effect of ACAG elevation on survival outcome was statistically significant(both P<0.001),both as a quantitative variable and as a grouping variable.ROC curves showed that ACAG showecl a higher predictive value for 30-day death compared with AG and albumin,and the differences were statistically significant(both P<0.001).Conclusion:Elevated ACAG is an independent predictor of 30-day all-cause death for AMI patients.

关 键 词：急性心肌梗死 清蛋白校正阴离子间隙 重症监护医学信息数据库 预后 

分 类 号：R542.22[医药卫生—心血管疾病]