修正休克指数及红细胞分布宽度可预测老年急性心肌梗死患者再发不良心血管事件

The modified shock index and red blood cell distribution width can predict recurrent adverse cardiovascular events in elderly patients with acute myocardial infarction

目的:评价修正休克指数(MSI)及红细胞分布宽度(RBCDW)对老年急性心肌梗死(AMI)患者短期预后的预测价值。方法:收集老年AMI患者500例,随访1年,根据出院后是否再发不良心血管事件,将患者分为不良预后组(98例)和对照组(402例)。比较2组患者临床特征、MSI及RBCDW差异,使用受试者工作特性曲线(ROC)比较MSI及RBCDW对老年AMI患者的预测价值。结果:与对照组比较,不良预后组MSI及RBCDW增加(P均<0.05);2组患者白细胞计数(WBC)比较,差异无统计学意义(P>0.05)。MSI对老年AMI患者再发不良心血管事件的预测价值最高,曲线下面积为0.775(95%CI:0.721~0.829,P=0.000);RBCDW对老年患者再发不良心血管事件具有较好预测价值(P<0.05)。多因素logistics回归分析显示MSI及RBCDW均是老年AMI患者再发不良心血管事件的危险因素(P均<0.05)。结论:MSI及RBCDW对预测老年AMI患者再发不良心血管事件具有一定价值,但MSI价值更高。

Objective:To compare the short term prognostic value of modified shock index and red blood cell distribution width in elderly patients with acute myocardial infarction(AMI).Methods:A total of 500 elderly patients with AMI were collected and followed up for 1 year.According to whether the patients had recurrent adverse cardiovascular events after discharge,the patients were divided into a poor prognosis group(n=98)and a control group(n=402).The differences in clinical characteristics,modified shock index and red blood cell distribution width between the two groups were compared.The predictive value of modified shock index and red blood cell distribution width in elderly patients with AMI were compared by ROC curve.Results:Compared with the control group,MSI and RBCDW in the poor prognosis group were increased(P<0.05).There was no significant difference in white blood cell count between the two groups(P>0.05).The modified shock index had the highest predictive value for the recurrence of adverse cardiovascular events in elderly patients with AMI.The area under the curve was 0.775(95%confidence interval 0.721-0.829,P=0.000).Multivariate logistic regression analysis showed that modified shock index and red blood cell distribution width were risk factors for recurrent adverse cardiovascular events in elderly patients with AMI(P<0.05).Conclusion:The modified shock index and red blood cell distribution width have certain value in predicting the recurrence of adverse cardiovascular events in elderly patients with AMI,but modified shock index has higher value.