新型人体测量学指标与急性心肌梗死患者长期预后的相关性  

Correlation of novel anthropometric indicators with long-term prognosis in patients with acute myocardial infarction

作　　者：王凯阳 陶静[1,2] 吴婷婷[3] 永佳蕙 李国庆[1,2] 谢翔[3] 杨毅宁 WANG Kaiyang;TAO Jing;WU Tingting;YONG Jiahui;LI Guoqing;XIE Xiang;YANG Yining(Department of Cardiology,Xinjiang Uygur Autonomous Region People′s Hospital,Urumqi 830000,Xinjiang,China;Xinjiang Key Laboratory of Cardiovascular Homeostasis and Regenerative Medicine,Urumqi 830000,Xinjiang,China;不详)

机构地区：[1]新疆维吾尔自治区人民医院心内科,新疆乌鲁木齐830000 [2]新疆维吾尔自治区人民医院新疆心脏血管稳态与再生医学研究重点实验室,新疆乌鲁木齐830000 [3]新疆医科大学第一附属医院心脏中心,新疆乌鲁木齐830011

出　　处：《实用医学杂志》2024年第21期3040-3046,共7页The Journal of Practical Medicine

基　　金：新疆维吾尔自治区“科技创新领军人才项目-高层次领军人才”项目(编号:2022TSYCLJ0028)。

摘　　要：目的 探讨新型人体测量学指标对急性心肌梗死(AMI)患者长期预后的预测价值。方法连续纳入2018年1月至2019年12月期间就诊于新疆维吾尔自治区人民医院明确诊断为AMI的712例患者作为研究对象,根据随访期间是否发生主要心血管不良事件(MACEs)分为事件组和非事件组。Gensini评分用以定量评估冠脉病变程度,Spearman相关性分析探讨新型人体测量学指标与Gensini评分的相关性;受试者工作特征(ROC)曲线评估新型人体测量学指标对MACEs的预测能力,依据最佳截断值分组,Kaplan-Meier曲线分析组间生存差异;多因素Cox回归模型分析MACEs发生的独立影响因素。结果 中位随访时间27(20,39)个月,共有125例患者发生MACEs,与非事件组患者相比,事件组患者合并高血压、糖尿病、腹型肥胖的比例更高,HbA1c和FBG水平更高,体质量及腰围较大,LAP指数、CMI指数、BRI指数及Gensini评分明显升高(P<0.05);Spearman相关性分析显示:LAP指数、CMI指数及BRI指数与Gensini评分呈正相关(r=0.233、0.126、0.272,P <0.001);ROC曲线分析结果显示:LAP指数、CMI指数、VAI指数、BRI指数及ABSI指数的AUC分别为0.745、0.640、0.490、0.874、0.506;Kaplan-Meier曲线分析结果显示:LAP指数、CMI指数和BRI指数高值组患者MACEs累积发生率显著增加(Log-rank test,P<0.05);调整混杂后多因素Cox回归分析结果显示:CMI指数(HR=1.430,95%CI:1.049~1.952,P=0.024)和BRI指数(HR=1.332,95%CI:1.234~1.439,P<0.001)是MACEs发生的独立危险因素。结论 新型人体测量学指标CMI指数和BRI指数是AMI患者长期预后的独立危险因素。Objective To explore the predictive value of novel anthropometric indicators for the long-term prognosis in patients with acute myocardial infarction(AMI).Methods A total of 712 patients diagnosed with AMI in the People's Hospital of Xinjiang Uygur Autonomous Region from January 2018 to December 2019 were selected as research subjects,and divided into an event group and a non-event group according to whether major cardiovascular adverse events(MACEs) occurred during the period of follow-up.Gensini score was used to quantitatively assess the degree of coronary artery stenosis.Spearman correlation analysis was used to explore the correlation between the new anthropometric indicators and Gensini score.Receiver operating characteristic(ROC) curve was used to evaluate the ability of new anthropometric indicators to predict MACEs,and the patients were grouped according to the optimal cut-off value.Kaplan-Meier curve was used to analyze the survival difference between the groups.Multivariate Cox regression was used to analyze the independent risk factors of MACEs.Results During a median follow-up of 27(20,39)months,a total of 125 patients developed MACEs.As compared with those in the non-event group,the patients in the event group had a higher proportion of hypertension,diabetes and abdominal obesity,higher HbA1c and FBG levels,and longer body weight and waist circumference.The LAP index,CMI index,BRI index and Gensini score were significantly increased,and the differences were statistically significant(P ? 0.05).Spearman correlation analysis showed that LAP index,CMI index and BRI index were positively correlated with Gensini score(r = 0.233,0.126,0.272,P < 0.001).ROC curve analysis showed that the AUC of LAP index,CMI index,VAI index,BRI index and ABSI index were 0.745,0.640,0.490,0.874 and 0.506 respectively;Kaplan-Meier curve analysis showed that the cumulative incidence of MACEs in LAP index,CMI index and BRI index was significantly increased in the high-value group(Log-rank test,P ? 0.05).The results of multivaria

关 键 词：新型人体测量学指标 内脏型肥胖 急性心肌梗死 GENSINI评分 预后 

分 类 号：R542.22[医药卫生—心血管疾病]