晚期肺癌炎症指数对老年ACS患者预后的预测价值

The predictive value of inflammation index in advanced lung cancer for prognosis in elderly patients with ACS

目的探讨晚期肺癌炎症指数对老年急性冠状动脉综合征患者经皮冠状动脉介入术后全因死亡率的预测价值。方法选取2018年1月至2018年12月杭州市第一人民医院接受PCI治疗的老年ACS患者366例,根据入院时ALI最佳截断值分为两组,低ALI组120例,高ALI组246例。术后连续随访36个月。采用ROC曲线、多因素COX回归分析和Kaplan-Meier曲线评估ALI对患者全因死亡率的预测价值。结果ALI预测老年ACS患者发生全因死亡的ROC曲线下面积为0.737(95%CI:0.677~0.798,P<0.001)。多因素COX回归分析中,年龄(HR=0.959,95%CI:0.922~0.998,P=0.038)、ALI(HR=0.950,95%CI:0.903~0.998,P=0.042)和GRACE(HR=1.031,95%CI:1.023~1.039,P<0.001)是老年ACS患者全因死亡的独立预测因素。Kaplan-Meier曲线显示,低ALI组老年ACS患者的中位生存期短于ALI组,差异有统计学意义(P<0.001)。结论ALI与老年ACS患者的全因死亡存在相关性,老年ACS患者入院时的低ALI水平是PCI术后全因死亡的独立危险因素。ALI可能有助于评估老年ACS患者预后。

Objective To investigated the predictive value of advanced lung cancer inflammation index(ALI)for all-cause mortality in elderly patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods Related clinical data were collected from the elderly ACS patients in the First People's Hospital of Hangzhou,and the patients were divided into a low ALI group(ALI<20.52)and a high ALI group(ALI≥20.52)according to the optimal cutoff value of ALI on admission.The receiver operating characteristic(ROC)curve,multifactorial COX regression analysis,and Kaplan-Meier curve were used to assess the predictive value of ALI for all-cause mortality.Results The ROC curves showed that the AUC for ALI was 0.737(95%CI:0.677~0.798,P<0.001)in predicting all-cause mortality in elderly ACS patients.The multivariate COX regression analysis demonstrated that age(HR=0.959,95%CI:0.922~0.998,P=0.038),ALI(HR=0.950,95%CI:0.903~0.998,P=0.042)and GRACE(HR=1.031,95%CI:1.023~1.039,P<0.001)were independent risk factors for the incidence of all-cause mortality.Kaplan-Meier curve showed that,compared with the high ALI group,median survival was shorter in elderly ACS patients in the low ALI group,and the difference was statistically significant(P<0.001).Conclusion ALI is associated with all-cause mortality in elderly ACS patients,and low ALI levels on admission are an independent risk factor for all-cause mortality in elderly ACS patients after PCI.Therefore,ALI may be useful in assessing the prognosis of elderly ACS patients.