血尿酸/肌酐比值对急性心肌梗死患者心力衰竭发生的预测分析

Predictive analysis of serum uric acid/creatinine ratio on heart failure in patients with acute myocardial infarction

目的观察急性心肌梗死患者血尿酸/肌酐比值与心力衰竭发生的关系,研究其在心力衰竭发生预测中的应用价值。方法纳入2019年1月一2022年12月医院110例急性心肌梗死患者为研究对象,进行前瞻性研究,所有患者人院时均接受血尿酸、肌酐水平检测,随访6个月,观察患者心力衰竭发生状况,将其分为发生组与未发生组,并分析血尿酸/肌酐预测急性心肌梗死患者心力衰竭的价值。结果随访6个月,110例急性心肌梗死患者中发生心力衰竭23例(20.91%);发生组Killip分级、尿酸、尿酸/肌酐比值、C-反应蛋白水平高于未发生组,差异有统计学意义(P<0.05);经Mantel-Haenszel卡方检验,Killip分级与急性心肌梗死患者发生心力衰竭成正相关(r>0,P<0.05);经点二列相关性分析,尿酸、尿酸/肌酐比值、C-反应蛋白与急性心肌梗死患者发生心力衰竭成正相关(r>0,P<0.05);绘制受试者工作特征曲线(ROC),结果显示,血尿酸/肌酐比值预测急性心肌梗死患者发生心力衰竭的AUC>0.7,具有一定预测价值。结论急性心肌梗死患者人院治疗前与患者治疗后短期发生心力衰竭密切相关,同时血尿酸/肌酐比值结合Killip分级、C-反应蛋白等指标联合应用可很好反应急性心肌梗死患者治疗后的短期预后情况。

Objective This paper aims to observe the relationship between serum uric acid/creatinine ratio and the occurrence of heart failure in patients with acute myocardial infarction,so as to study its application value in predicting the occurrence of heart failure.Methods A total of 110 patients with acute myocardial infarction in the hospital from January 2019 to December 2022 were enrolled in the prospective study.All patients received the detection of blood uric acid and creatinine levels at admis-sion and following-up for 6 months.The occurrence of heart failure in patients was observed and divided into occurrence group and non-occurrence group,and the value of serum uric acid/creatinine in predicting heart failure in patients with acute myo-cardial infarction was analyzed.Results Following-up for 6 months showed that heart failure occurred in 23(20.91%)of 110 patients with acute myocardial infarction.Killip grade,uric acid,uric acid/creatinine ratio and C-reactive protein level in the occurrence group were higher than those in the non-occurrence group,with the differences statistically significant(P<0.05).Mantel-Haenszel Chi-square test showed that Killip grade was positively correlated with heart failure in patients with acute myocardial infarction(r>0,P<0.05).Point binary correlation analysis showed that uric acid,uric acid/creatinine ratio,C-reactive protein were positively correlated with heart failure in patients with acute myocardial infarction(r>O,P<O.05).The receiver operating characteristic curve(ROC)showed that the blood uric acid/creatinine ratio could predict the AUC of heart failure in patients with acute myocardial infarction>0.7,which had certain predictive value.Conclusion Heart failure in patients with acute myocardial infarction is closely related to the short-term occurrence of heart failure before admis-sion and after treatment.Meanwhile,the combination of serum uric acid/creatinine ratio,Killip grade,C-reactive protein and other indicators can effectively reflect the short-term prognosis of patients with acute myocardial infarction after treatment.