入院中性粒细胞与白蛋白比值和葡萄糖与淋巴细胞比值与急性心肌梗死患者院内死亡的相关性研究  

The correlation of neutrophil-to-albumin ratio and glucose-to-lymphocyte ratio with the in-hospital death in patients with acute myocardial infarction

作　　者：冯淑惠 张天行 夏经钢[1] 尹春琳[1] Feng Shuhui;Zhang Tianxing;Xia Jinggang;Yin Chunlin(Department of Cardiology,Xuanwu Hospital,Capital Medical University,National Clinical Research,Center for Geriatric Diseases,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院心脏内科、国家老年疾病临床医学研究中心,北京100053

出　　处：《中国医师进修杂志》2025年第3期202-209,共8页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨入院中性粒细胞与白蛋白比值(NAR)和葡萄糖与淋巴细胞比值(GLR)与急性心肌梗死(AMI)患者院内死亡的相关性。方法回顾性分析首都医科大学宣武医院2017年1月至2022年12月2657例AMI患者的临床资料。采用受试者工作特征(ROC)曲线确定入院GLR和NAR预测AMI患者发生院内死亡的最佳截断值(6.02和0.25)将患者进行分组,其中768例GLR≥6.02(高GLR组),1889例GLR<6.02(低GLR组);547例NAR≥0.25(高NAR组),2110例NAR<0.25(低NAR组)。记录患者的基线特征和院内主要不良心血管事件(MACE)发生情况。采用多因素Logistic回归分析影响AMI患者发生院内死亡的独立危险因素。结果2657例AMI患者院内发生MACE 265例(10.0%),其中死亡50例(1.9%)。高GLR组年龄、Killip≥2级比例、糖尿病比例、心肌梗死史比例、脑梗死史比例、ST段抬高型心肌梗死(STEMI)比例、心肌梗死溶栓治疗临床试验评分(TIMI评分)、全球急性冠状动脉事件注册评分(GRACE评分)、纤维蛋白原、空腹血糖、糖化血红蛋白、高密度脂蛋白胆固醇(HDL-C)、心肌肌钙蛋白I(cTnI)峰值、N末端B型利钠肽原(NT-proBNP)、超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、NAR、GLR、中性粒细胞计数、左心室舒张末期内径(LVEDD)明显高于低GLR组,男性比例、体质量指数(BMI)、吸烟史比例、非ST段抬高型心肌梗死(NSTEMI)比例、白蛋白、估算肾小球滤过率(eGFR)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、淋巴细胞计数、单核细胞计数和左心室射血分数(LVEF)明显低于低GLR组,差异有统计学意义(P<0.01或<0.05)。高NAR组Killip≥2级比例、STEMI比例、TIMI评分、GRACE评分、纤维蛋白原、空腹血糖、TC、LDL-C、cTnI峰值、hs-CRP、IL-6、NAR、GLR、白细胞计数、中性粒细胞计数和单核细胞计数明显高于低NAR组,年龄、心肌梗死史比例、NSTEMI比例、白蛋白、淋巴细胞计数、左心房内径(LADObjective To investigate the correlation of neutrophil-to-albumin ratio(NAR)and glucose-to-lymphocyte ratio(GLR)with in-hospital death in patients with acute myocardial infarction(AMI).Methods The clinical data of 2657 patients with AMI from January 2017 to December 2022 in Xuanwu Hospital,Capital Medical University were retrospectively analyzed.Using receiver operating characteristic(ROC)curve to determine the optimal cutoff values of GLR and NAR(6.02 and 0.25)for predicting in-hospital mortality in patients with AMI,the patients were divided into high GLR group(GLR≥6.02,768 cases)and low GLR group(GLR<6.02,1889 cases),high NAR group(NAR≥0.25,547 cases)and low NAR group(NAR<0.25,2110 cases)according the optimal cutoff values.The baseline characteristics and occurrence of in-hospital major adverse cardiovascular events(MACE)were recorded.Multivariate Logistic regression was used to analyze the independent risk factors for in-hospital death in patients with AMI.Results Among the 2657 patients with AMI,265 patients had in-hospital MACE(10.0%),and 50 patients(1.9%)died.The age,proportion of Killip≥2 grade,proportion of diabetes,proportion of myocardial infarction,proportion of cerebral infarction history,proportion of ST-elevation myocardial infarction(STEMI),thrombolysis in myocardial infarction clinical trial score(TIMI score),global registry of acute coronary event score(GRACE score),fibrinogen,fasting blood glucose,glycated hemoglobin,high-density lipoprotein cholesterol(HDL-C),cardiac troponin I(cTnI)peak,N-terminal B-type natriuretic peptide(NT-proBNP),hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),NAR,GLR,neutrophil count,left ventricular end-diastolic diameter(LVEDD)in high GLR group were significantly higher than those in low GLR group,the proportion of males,body mass index(BMI),proportion of smoking history,proportion of non-ST elevation myocardial infarction(NSTEMI),albumin,estimated glomerular filtration rate(eGFR),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),tri

关 键 词：心肌梗死 医院死亡率 预后 中性粒细胞与白蛋白比值 葡萄糖与淋巴细胞比值 

分 类 号：R54[医药卫生—心血管疾病]