AMI患者PCI术后发生MACE的危险因素分析

【摘要】 目的 探讨急性心肌梗死（AMI）患者经皮冠状动脉介入（PCI）术后发生主要心血管不良事件（MACE）的危险因素。方法选取2020年1月至2023年12月接受PCI治疗急性心肌梗死（AMI）患者200例，根据术后是否发生MACE将患者分为不良组（41例）和良好组（159例）。随访术后12个月内首次来院复诊的临床资料及血液指标，比较两组差异。采用单因素和多因素Logistic回归分析PCI术后发生MACE的影响因素，绘制受试者操作特征曲线（ROC）评估各因素对MACE的预测价值。结果 单因素分析结果显示，术前C反应蛋白（CRP）、术前葡萄糖、术前尿素氮、术前中性粒细胞与淋巴细胞比值（NLR）、术前淋巴细胞计数、术前NT-proBNP、复诊肌钙蛋白T(cTNT)、复诊月份、复诊血红蛋白（HGB）、复诊左室射血分数（LVEF）、复诊NT-proBNP两组比较差异均有统计学意义（P<0.05）。多因素Logistic回归分析显示，术前肌酐和术前NLR是PCI术后MACE的影响因素。ROC分析显示，复诊LVEF、复诊HGB、术前NLR和术前肌酐联合预测的曲线下面积（AUC）为0.851，联合预测效能较高。结论 术前肌酐和术前NLR是PCI术后MACE的影响因素，复诊LVEF、复诊HGB、术前NLR和术前肌酐联合检测评估AMI患者PCI术后发生MACE具有较高的预测效能。更多还原

【Abstract】 Objective To explore the risk factors for major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI in patients with acute myocardial infarction(AMI).Methods A total of 200 AMI patients treated with PCI from January 2020 to December 2023 were enrolled.Based on the occurrence of MACE postoperatively,the patients were divided into an adverse group(41 cases)and a favorable group(159 cases).Clinical data and blood indicators from the first follow-up within 12 months after surgery were collected,and differences between the two groups were compared.Univariate and multivariate logistic regression analyses were performed to identify influencing factors of MACE after PCI.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive value of each factor for MACE.Results Univariate analysis showed significant differences between the two groups in preoperative C-reactive protein(CRP),preoperative glucose,preoperative blood urea nitrogen,preoperative neutrophilto-lymphocyte ratio(NLR),preoperative lymphocyte count,preoperative NT-proBNP,follow-up troponin T(cTNT),follow-up month,follow-up hemoglobin(HGB),follow-up left ventricular ejection fraction(LVEF),and follow-up NT-proBNP(all P <0.05).Multivariate logistic regression analysis revealed that preoperative creatinine and preoperative NLR were independent influencing factors for MACE after PCI.ROC analysis demonstrated that the combined prediction of follow-up LVEF,follow-up HGB,preoperative NLR,and preoperative creatinine yielded an area under the curve(AUC)of 0.851,indicating high predictive efficacy.Conclusion Preoperative creatinine and preoperative NLR are influencing factors for MACE after PCI.The combined assessment of follow-up LVEF,follow-up HGB,preoperative NLR,and preoperative creatinine has high predictive value for MACE in AMI patients post-PCI.更多还原