术前血尿素氮/白蛋白比值与冠状动脉血管内超声指导下经皮冠状动脉介入术患者预后的关系  

Relationship between preoperative blood urea nitrogen/albumin ratio and prognosis of patients undergoing percutaneous coronary intervention guided by intravascular ultrasound

作　　者：陈斌 许岭平 秦黎明 卫聪颖 韩芳旗 Chen Bin;Xu Lingping;Qin Liming;Wei Congying;Han Fangqi(Department of Cardiovascular,Xianyang Central Hospital,Xianyang 712000,China)

机构地区：[1]咸阳市中心医院心血管内科,咸阳712000

出　　处：《中国医师杂志》2025年第3期377-381,共5页Journal of Chinese Physician

基　　金：陕西省重点研发计划项目(2022SF-291)。

摘　　要：目的分析术前血尿素氮(BUN)/白蛋白(ALB)比值(B/A)与冠状动脉血管内(简称冠脉内)超声指导下经皮冠状动脉介入术(PCI)患者预后的关系。方法回顾性选择2020年2月—2022年12月在咸阳市中心医院行冠脉内超声指导下PCI治疗的116例患者作为观察组,另外以同期健康体检人群120例作为对照组。所有患者术后均随访1年,以随访期间出现主要不良心血管事件(MACE)为终点事件将116例患者分为预后不良组(n=33)与预后良好组(n=83)。所有受试者入院后均检测外周血BUN、ALB水平,并计算B/A。分析比较各组基础资料、生化指标及B/A,采用受试者工作特征(ROC)曲线分析术前BUN、ALB、B/A对冠脉内超声指导下PCI患者术后发生MACE的预测价值;采用多因素logistic回归分析评估冠脉内超声指导下PCI患者术后发生MACE的相关影响因素。结果观察组左心室舒张末内径(LVEDD)、N末端B型利钠肽原(NT-proBNP)、肌酸激酶同工酶(CK-MB)、BUN、B/A均高于对照组,左室射血分数(LVEF)、ALB均低于对照组(均P<0.05)。预后不良组NT-proBNP、CK-MB、BUN、B/A均高于预后良好组,LVEF、ALB均低于预后良好组(均P<0.05)。ROC曲线结果显示,外周血BUN、ALB及B/A预测冠脉内超声指导下PCI患者术后发生MACE的AUC为0.833(95%CI:0.783~0.883)、0.859(95%CI:0.809~0.909)、0.922(95%CI:0.872~0.972)。多因素logistic回归分析显示,LVEF[OR(95%CI)=1.952(1.317~2.895)]、NT-proBNP[OR(95%CI)=2.625(1.643~4.193)]、BUN[OR(95%CI)=3.353(1.922~5.851)]、ALB[OR(95%CI)=3.792(2.049~7.018)]、B/A[OR(95%CI)=3.277(2.000~5.370)]均为冠脉内超声指导下PCI患者术后发生MACE的影响因素(均P<0.05)。结论冠脉内超声指导下PCI患者术前B/A水平升高,且高水平B/A是患者术后MACE发生的危险因素,可作为评估冠脉内超声指导下PCI患者术后发生MACE的生物学指标。ObjectiveTo analyze the relationship between blood urea nitrogen(BUN)/albumin(ALB)ratio(B/A)and prognosis of patients undergoing percutaneous coronary intervention(PCI)guided by ultrasound before operation.MethodsA total of 116 patients who underwent PCI under the guidance of intra-coronary ultrasound in Xianyang Central Hospital from February 2020 to December 2022 were retrospectively selected as the observation group,and 120 healthy people in the same period were selected as the control group.All patients were followed up for 1 year after surgery,and 116 patients were divided into poor prognosis group(n=33)and good prognosis group(n=83),taking major adverse cardiovascular events(MACE)as the end point during follow-up.The levels of BUN and ALB in peripheral blood of all subjects were detected after admission,and B/A was calculated.The basic data,biochemical indexes and B/A of each group were analyzed and compared.The predictive value of preoperative BUN,ALB and B/A on postoperative MACE in patients with PCI guided by intra-coronary ultrasound was analyzed by receiver operating characteristic(ROC)curve.Multivariate logistic regression analysis was used to evaluate the related influencing factors of postoperative MACE in patients with PCI guided by intra-coronary ultrasound.ResultsThe left ventricular end-diastolic inner diameter(LVEDD),N-terminal B-type natriuretic peptide(NT-proBNP),creatine kinase isoenzyme(CK-MB),BUN and B/A in the observation group were higher than those in the control group,and left ventricular ejection fraction(LVEF)and ALB were lower than those in the control group(all P<0.05).NT-proBNP,CK-MB,BUN and B/A in the poor prognosis group were higher than those in the good prognosis group,and LVEF and ALB were lower than those in the good prognosis group(all P<0.05).ROC curve results showed that the AUC of peripheral blood BUN,ALB and B/A predicting postoperative MACE in patients with PCI guided by intra-coronary ultrasound were 0.833(95%CI:0.783-0.883),0.859(95%CI:0.809-0.909)and 0.922(95%CI:0.8

关 键 词：经皮冠状动脉介入治疗 超声检查 血管内 血尿素氮 白蛋白 

分 类 号：R541.4[医药卫生—心血管疾病]