TIMI评分联合NLR、IL-6对老年非ST段抬高型心肌梗死患者MACE的预测价值

Predictive value of TIMI score combined with NLR and IL-6 on MACE in elderly patients with NSTEMI

目的探讨心肌梗死溶栓治疗危险评分(TIMI risk score)联合中性粒细胞与淋巴细胞比值(NLR)、白细胞介素-6(IL-6)对急诊老年非ST段抬高型心肌梗死(NSTEMI)患者院内主要不良心血管事件(MACE)的预测价值。方法选取老年NSTEMI患者89例。对比发生组和未发生组患者的临床资料。Logistic回归进行多因素分析。绘制受试者工作特征(ROC)曲线并以曲线下面积(AUC)评价预测效能。结果急诊老年NSTEMI患者院内MACE发生率为25.84%。MACE发生组中的年龄、合并糖尿病占比、既往心梗史占比、既往脑卒中史占比、血肌酐、尿酸、WBC、NE%、NLR、IL-6及TIMI危险评分(分值)均高于未发生组(P<0.05)。Logistic回归多因素分析结果显示,年龄、NLR及IL-6均为急诊老年NSTEMI患者院内MACE发生的独立危险因素(P<0.05)。ROC曲线显示,TIMI危险评分、NLR及IL-6联合预测NSTEMI患者院内MACE发生的AUC为0.970,高于其单独预测的AUC.结论TIMI危险评分、NLR及IL-6三者联合对急诊老年NSTEMI患者院内MACE发生的预测效能较高。

Objective To investigate the predictive value of the thrombolysis in myocardial infarction risk score (TIMI risk score) combined with the neutrophil-to-lymphocyte ratio (NLR) and interleukin-6 (IL-6) for in-hospital major adverse cardiovascular events (MACE) in elderly patients with the emergency non-ST-segment elevation myocardial infarction (NSTEMI).Methods A total of 89 elderly NSTEMI patients admitted to the emergency department of Xuanwu Hospital of Capital Medical University from April 2018 to October 2020 were selected.The clinical data of the patients in the occurrence group and the non-occurrence group were compared.Logistic regression was used for a multivariate analysis.Receiver operating characteristic (ROC) curves were drawn and the prediction efficiency was evaluated by the area under the curve (AUC).Results The incidence of in-hospital MACE in the emergency elderly NSTEMI patients was 25.84%.Age,proportion of diabetes mellitus,proportion of history of myocardial infarction,proportion of history of stroke,serum creatinine,uric acid,WBC,NE%,NLR,IL-6 and TIMI risk score in the MACE group were all higher than those in the non-occurring group (P<0.05).The Logistic regression multivariate analysis showed that age,NLR and IL-6 were independent risk factors for the occurrence of in-hospital MACE in the emergency elderly NSTEMI patients (P<0.05).The ROC curve showed that the AUC predicted by the combination of TIMI risk score,NLR and IL-6 was 0.970 in NSTEMI patients,which was higher than the AUC predicted by the TIMI risk score alone.Conclusion The combination of the TIMI risk score,NLR and IL-6 has a high predictive power for the occurrence of in-hospital MACE in emergency elderly NSTEMI patients.