摘要
目的:探究联合检测NLR、cTnⅠ及NT-proBNP水平预测冠状动脉3支病变患者行冠状动脉旁路移植(coronary artery bypass grafting,CABG)术后发生院内主要心血管不良事件(major adverse cardiovascular events,MACE)风险的价值。方法:回顾性分析2019年1月至2019年7月,于首都医科大学附属北京安贞医院心脏外科中心行CABG术的冠心病(3支冠状动脉狭窄)患者574例,根据医院记录和电话访谈记录其院内MACE包括新发心室颤动、低心输出量综合征(low cardiac output syndrome,LCOS)、主动脉内球囊反搏(intra-aortic ballon pump,IABP)的使用和全因死亡,分为MACE组(n=55)和非MACE组(n=519),收集患者的基本临床资料和入院24 h内NLR、cTnI及NT-proBNP检查结果,进行组间比较,分析上述指标单独及联合检测对冠状动脉多支病变患者行CABG术后发生院内MACE风险的预测效能。结果:院内发生MACE患者NLR、cTnI及NT-proBNP水平均显著高于院内未发生MACE(非MACE)组,差异有统计学意义(P<0.05)。在单独预测冠状动脉多支病变患者行CABG术后发生院内MACE风险方面,NT-proBNP的曲线下面积最大,为0.848(P<0.001),NT-proBNP的敏感性最高,为83.6%。与单独预测相比,各指标联合预测的曲线下面积提高为0.92(P<0.001),敏感性提高为92.7%。结论:联合检测NLR、cTnI及NT-proBNP水平对预测冠状动脉三支病变患者行CABG术后院内MACE风险具有一定的价值,值得在临床上推广。
Objective:To investigate the value of NT-proBNP levels in predicting the risk of in-hospital major adverse cardiovascular events(MACE)in patients with three-vessel coronary artery disease(TVD)undergoing coronary artery bypass grafting(CABG).Methods:A total of 574 patients with coronary heart disease(three-vessel coronary artery stenosis)who underwent CABG in the Cardiac Surgery Center of Beijing Anzhen Hospital,Capital Medical University from January 2019 to July 2019 were retrospectively analyzed.In-hospital MACE including new-onset ventricular fibrillation,Low cardiac output syndrome(LCOS),use of intra-aortic balloon pump(IABP)and all-cause death were recorded according to hospital records and telephone interviews.The patients were divided into MACE group(n=55)and non-MACE group(n=519).The basic clinical data and the results of NLR,cTnI and NT-proBNP within 24 hours after admission were collected and compared between the two groups.The predictive efficacy of the above indicators alone and in combination on the risk of in-hospital MACE after CABG in patients with multi-vessel coronary artery disease was analyzed.Results:NLR,cTnI and NT-proBNP levels in patients with MACE during hospitalization were significantly higher than those in patients without MACE(non-MACE)during hospitalization,and the difference was statistically significant(P<0.05).NT-proBNP had the largest area under the curve(AUC)of 0.848(P<0.001)and the highest sensitivity in predicting the risk of in-hospital MACE after CABG in patients with multi-vessel coronary artery disease.And 83.6%.Compared with individual prediction,the area under the curve of combined prediction was increased by 0.92(P<0.001),and the sensitivity was increased by 92.7%.Conclusions:Combined detection of NLR,cTnI and NT-proBNP levels has certain value in predicting the risk of in-hospital MACE in patients with three-vessel coronary artery disease after CABG,which is worthy of clinical promotion.
作者
叶钊飞
李国庆
张晨昊
赵广鹏
李平
YE Zhaofei;LI Guoqing;ZHANG Chenhao;ZHAO Guangpeng;LI Ping(Deparment of Cardiovascular Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)
出处
《心肺血管病杂志》
CAS
2023年第6期578-582,共5页
Journal of Cardiovascular and Pulmonary Diseases
基金
国家自然科学基金(81870339)。