血尿素氮与白蛋白比值对急性心肌梗死老年患者PCI后发生心力衰竭的预测价值  

Predictive value of the ratio of blood urea nitrogen to albumin for heart failure occurred after PCI in elderly patients with acute myocardial infarction

作　　者：李栋 程龙 赵彩芹 陆业成 王玉宝 LI Dong;CHENG Long;ZHAO Caiqin;LU Yecheng;WANG Yubao(Department of Cardiology,Lianyungang Municipal Oriental Hospital,Lianyungang 222042,CHINA)

机构地区：[1]连云港市立东方医院心血管内科,江苏222042

出　　处：《江苏医药》2025年第1期47-51,共5页Jiangsu Medical Journal

摘　　要：目的 评估血尿素氮与白蛋白比值(BAR)对急性心肌梗死(AMI)老年患者经皮冠状动脉介入治疗(PCI)后发生心力衰竭(HF)的预测价值。方法 回顾性分析行PCI的206例AMI老年患者的临床资料,根据住院期间是否发生HF分为A组(发生HF,96例)和B组(未发生HF,110例)。比较两组临床资料,分析AMI老年患者PCI后发生HF的危险因素,绘制ROC曲线评估BAR对AMI老年患者PCI后发生HF的预测价值。结果 两组男性比例、年龄、心率、高血压比例、糖尿病比例、吸烟史比例、TC、TG、HDL-C、LDL-C、ALT、AST以及梗死相关血管方面均无统计学差异(P>0.05)。两组BMI、BUN、SCr、白蛋白、肌钙蛋白I、脑利尿钠肽、BAR以及左心室射血分数(LVEF)比较有统计学差异(P<0.05)。多因素logistic回归分析结果显示,高BAR是AMI老年患者发生HF的独立危险因素,高LVEF和高BMI是保护性因素(P<0.05)。BAR、LVEF和BMI预测AMI老年患者PCI后发生HF的AUC分别为0.878[95%CI(0.832~0.923)]、0.656[95%CI(0.581~0.731)]和0.691[95%CI(0.619~0.763)]。BAR取最佳诊断界值为0.225mmol/g时,预测AMI老年患者PCI后发生HF的灵敏度为86.5%,特异度为73.6%。结论 BAR是AMI老年患者PCI后发生HF的独立影响因素,具有较高的预测价值。Objective To assess the predictive value of blood urea nitrogen to albumin ratio(BAR)for the occurrence of heart failure(HF)after PCI in elderly patients with acute myocardial infarction(AMI).Methods A total of 206 elderly AMI patients treated with PCI were divided into two groups of A(with HF,96 cases)and B(without HF,110 cases).The data of the two groups were compared and the risk factors for HF after PCI were analyzed.The ROC curve was used to evaluate the predictive value of BAR for HF in elderly AMI patients after PCI.Results There were no significant differences between groups of A and B in the gender,age,heart rate,hypertension,diabetes,smoking,TC,TG,HDL-C,LDL-C,ALT,AST and infarction-related vessels(P>0.05).Groups of A and B showed significant differences in BMI,BUN,SCr,albumin,troponin I,brain natriuretic peptide,BAR and left ventricular ejection fraction(LVEF)(P<0.05).Multivariate logistic analysis showed that higher BAR was the independent risk factor for HF in elderly AMI patients after PCI,and higher LVEF and BMI were the protective factors(P<0.05).The AUC of BAR,LVEF and BMI predicting HF in elderly AMI patients after PCI were 0.878[95%CI(0.832-0.923)],0.656[95%CI(0.581-0.731)] and 0.691[95%CI(0.619-0.763)],respectively.When the best diagnostic threshold value of BAR was 0.225 mmol/g,the predicted sensitivity was 86.5%,and the specificity was 73.6%.Conclusion BAR is an independent risk factor for the occurrence of HF in elderly AMI patients after PCI and has high predictive value.

关 键 词：血尿素氮与白蛋白比值 急性心肌梗死 心力衰竭 

分 类 号：R542[医药卫生—心血管疾病]