NLR、NT-pro BNP、Lac和HRV对AMI合并CS患者30 d死亡事件的预测价值  

The Predictive Value of NLR,NT-proBNP,Lac and HRV for 30-Day Mortality Events in Patients of AMICS

作　　者：张世玉 李俊丽 陈红伟 ZHANG Shiyu;LI Junli;CHEN Hongwei(Fourth Clinical College,Xinxiang Medical College,Xinxiang Henan 453000,China;Department of Cardiovascular Medicine,Jincheng People′s Hospital,Jincheng Shanxi 048000,China;Department of Emergency,Xinxiang Central Hospital,Xinxiang Henan 453000,China)

机构地区：[1]新乡医学院第四临床学院,河南新乡453000 [2]晋城市人民医院心血管内科,山西晋城048000 [3]新乡市中心医院急诊科,河南新乡453000

出　　处：《中国卫生标准管理》2025年第4期110-113,共4页China Health Standard Management

基　　金：河南省医学科技攻关计划项目(LHGJ20210907)。

摘　　要：目的 探讨中性粒细胞与淋巴细胞计数比值(neutrophilto-lymphocyte ratio,NLR)、N末端B型利钠肽原(N-terminal pro-B-type natriureticpeptide,NT-pro BNP)、血乳酸(lactate,Lac)和心率变异性(heart rate variability,HRV)对急性心肌梗死(acute myocardial infarction,AMI)合并心源性休克(cardiogenic shock,CS)30 d死亡事件的预测价值。方法 采用回顾性分析的方法,选取晋城市人民医院2020年2月—2024年11月收治的接受经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗的急性心肌梗死合并心源性休克患者130例作为研究对象,收集全部患者的临床资料,对患者进行为期30 d的随访。记录患者入院后30 d内的死亡事件,探究NLR、NT-proBNP、Lac和HRV对AMI合并CS患者30 d死亡事件的预测价值。结果 死亡组与存活组的性别、基础疾病、吸烟史及饮酒史比较,差异无统计学意义(P> 0.05)。死亡组Lac、NLR及HRV分别为(6.24±3.51)mmol/L、(12.33±5.34)、(88.16±33.75)ms,存活组Lac、NLR及HRV分别为(3.78±2.67)mmol/L、(5.90±4.36)、(108.70±20.16)ms,差异有统计学意义(P <0.05)。2组NTPro BNP比较,差异无统计学意义(P> 0.05)。实施二元logistic分析可见,Lac、NLR和HRV可作为导致心肌梗死合并心源性休克患者死亡的预测因子(P <0.05)。实施受试者工作特征(receiver operating characteristic,ROC)曲线分析可见,Lac、NLR和HRV联合检测的AUC值高于单独检测的曲线下面积(area under curve,AUC)值(P <0.05)。结论 Lac、NLR和HRV被认为是AMI合并CS患者30 d死亡事件的重要预测因子,通过对Lac、NLR和HRV联合检查诊断可用于对患者30 d死亡风险事件的评估。Objective To explore neutrophil to lymphocyte ratio(NLR),N-terminal pro brain natriuretic peptide(NT-proBNP),the predictive value of blood lactate(Lac),and heart rate variability(HRV)for 30 day mortality events in patients with acute myocardial infarction(AMI)and cardiogenic shock(CS).Methods A retrospective analysis was conducted on approximately 130 patients with acute myocardial infarction complicated by cardiogenic shock who received percutaneous coronary intervention(PCI)treatment at Jincheng People′s Hospital from February 2020 to November 2024.Clinical data of all patients were collected and followed up for 30 days to observe the mortality events in the emergency department,hospitalization,or within 30 days after discharge.Record the death events of patients within 30 days after admission,and explore NLR,NT proBNP,Lac and HRV in AMI complicated with CS patients were explored.Results There were not statistically significant difference in gender,age,underlying disease,smoking history,and alcohol consumption history between the death group and the survival group(P>0.05).In the deceased group,the Lac,NLR and HRV levels were(6.24±3.51)mmol/L,(12.33±5.34),and(88.16±33.75)ms,respectively.In the survival group,the Lac,NLR and HRV levels were(3.78±2.67)mmol/L,(5.90±4.36)and(108.70±20.16)ms,respectively,the difference were statistically significant(P<0.05).There was no statistically significant difference between the two groups of NT-ProBNP(P>0.05).According to logistic analysis,Lac,NLR and HRV could serve as predictive factors for mortality in patients with myocardial infarction and cardiogenic shock(P<0.05).The implementation of receiver operating characteristic(ROC)curve analysis showed that the area under curve(AUC)value of Lac,NLR and HRV combined detection were significantly higher than that of individual detection(P<0.05).Conclusion Lac,NLR and HRV are considered important predictors of 30 day mortality events in AMI patients with concomitant CS.Combined examination and diagnosis of Lac,NLRand HRV can

关 键 词：血乳酸 中性粒细胞与淋巴细胞计数比值 氨基末端脑钠肽前体 心率变异性 急性心肌梗死 心源性休克 

分 类 号：R542[医药卫生—心血管疾病]