外周血BNP、NLR联合hsCRP/ALB检测对急性冠脉综合征患者PCI术后预后的预测价值  

Predictive Value of Peripheral Blood BNP and NLR Combined with hsCRP/ALB Ratio on Prognosis in Acute Coronary Syndrome Patients after PCI

作　　者：王月书 彭海燕[1] 郑永玲 WANG Yueshu;PENG Haiyan;ZHENG Yongling(Chengdu Third People’s Hospital,Chengdu 610014,China)

机构地区：[1]成都市第三人民医院,四川成都610014

出　　处：《北华大学学报(自然科学版)》2025年第2期215-220,共6页Journal of Beihua University(Natural Science)

基　　金：四川省科技计划项目(2023YFS0298)。

摘　　要：目的探讨外周血B型脑钠肽(BNP)、中性粒细胞与淋巴细胞比值(NLR)联合超敏C反应蛋白与白蛋白比值(hsCRP/ALB)检测对急性冠脉综合征(ACS)患者行经皮冠状动脉介入治疗(PCI)术后预后的预测价值。方法回顾性分析126例行PCI治疗的ACS患者资料,于入院后24 h内采集患者空腹静脉血测定外周血BNP、NLR、hsCRP/ALB水平,比较不同心功能的ACS患者外周血BNP、NLR及hsCRP/ALB水平,术后随访1 a,根据是否发生主要心脏不良事件(MACE)将患者分为预后良好组(n=93)和预后不良组(n=33),比较两组患者临床资料、外周血BNP、NLR及hsCRP/ALB水平,采用Cox回归分析影响ACS患者PCI术后预后的相关因素,采用受试者工作特征(ROC)曲线分析外周血BNP、NLR及hsCRP/ALB对ACS患者PCI术后预后的预测价值。结果Killip分级Ⅰ级患者外周血BNP、NLR及hsCRP/ALB水平显著低于Ⅱ级、Ⅲ级患者(P<0.5),Ⅱ级患者外周血BNP、NLR及hsCRP/ALB水平显著低于Ⅲ级患者(P<0.05);预后不良组患者年龄,BMI,Killip分级Ⅲ~Ⅳ级占比,Gensini积分,多个支架置入占比,血清LDL-C、Fib、hs-CRP、CTnI、NEU水平显著高于预后良好组(P<0.05,P<0.01),LVEF、LYM、血清ALB水平显著低于预后良好组(P<0.001);预后不良组患者外周血BNP、NLR及hsCRP/ALB显著高于预后良好组(P<0.001);多因素Cox回归分析显示,年龄,Killip分级,Gensini积分,外周血BNP、NLR及hsCRP/ALB是影响ACS患者PCI术后预后不良的危险因素(P<0.05,P<0.01);ROC曲线分析显示,外周血BNP、NLR及hsCRP/ALB单独及联合预测对ACS患者PCI术后预后的敏感度分别为75.76%、78.79%、81.82%、90.91%,特异度为72.04%、70.97%、69.89%、64.52%,AUC为0.753、0.797、0.835、0.935,联合检测价值更高。结论外周血BNP、NLR联合hsCRP/ALB检测对患者PCI术后预后具有较高的评估价值。Objective To investigate predictive value of peripheral blood B-type brain natriuretic peptide(BNP),neutrophil to lymphocyte ratio(NLR)combined with high-sensitivity C-reactive protein to albumin ratio(hsCRP/ALB)on prognosis in acute coronary syndrome(ACS)patients after percutaneous coronary intervention(PCI).Methods The data of 126 ACS patients who received PCI in hospital were retrospectively analyzed.Venous blood was collected within 24 h after admission to determine the levels of BNP,NLR and hsCRP/ALB in peripheral blood.The levels of peripheral blood BNP,NLR and hsCRP/ALB were compared among ACS patients with different cardiac function.At 1 year of follow-up after surgery,patients were divided into good prognosis group(n=93)and poor prognosis group(n=33)according to whether major adverse cardiac events(MACE)occurred.The clinical data and levels of peripheral blood BNP,NLR and hsCRP/ALB were compared between groups.Cox regression analysis was used to analyze related factors affecting prognosis in ACS patients after PCI.Receiver operating characteristic(ROC)curve was performed to analyze the predictive value of peripheral blood BNP,NLR and hsCRP/ALB on prognosis after PCI in ACS patients.Results The levels of peripheral blood BNP,NLR and hsCRP/ALB in Killip gradeⅠgroup were significantly lower than those in gradeⅡgroup and gradeⅢgroup(P<0.05),and the above levels were significantly lower in gradeⅡgroup than those in gradeⅢgroup(P<0.05).The age,BMI,proportions of Killip gradesⅢ~Ⅳ,Gensini score,proportion of multiple stent implantation,serum LDL-C,Fib,hs-CRP,CTnI and NEU in poor prognosis group were significantly higher than those in good prognosis group(P<0.05,P<0.01),while the LVEF,LYM and serum ALB were significantly lower than those in good prognosis group(P<0.001).The peripheral blood BNP,NLR and hsCRP/ALB were significantly higher in poor prognosis group than those in good prognosis group(P<0.001).Multivariate Cox regression analysis suggested that age,Killip grading,Gensini score,BNP,NLR and

关 键 词：B型脑钠肽 中性粒细胞与淋巴细胞比值 超敏C反应蛋白与白蛋白比值 急性冠脉综合征 经皮冠状动脉介入治疗 预后 预测价值 

分 类 号：R446[医药卫生—诊断学]