BNP、AngII、RDW及NLR对急性前壁心肌梗死患者术后左室收缩功能障碍的预测效能

Predictive efficacy of BNP,AngII,RDW and NLR for postoperative left ventricular systolic dysfunction in patients with acute anterior myocardial infarction

目的:探讨脑钠肽(BNP)、血管紧张素Ⅱ(AngⅡ)、红细胞分布宽度(RDW)及中性粒细胞/淋巴细胞比值(NLR)对急性前壁心肌梗死(AAMI)患者术后左室收缩功能障碍(LVSD)的预测效能。方法:选择我院2018年1月至2022年1月收治的160例AAMI患者,根据经皮冠脉介入术后的左室射血分数(LVEF)分为无LVSD组(LVEF>40%,110例)和LVSD组(LVEF≤40%,50例)。比较两组的基本资料,采用多因素Logistic回归分析AAMI患者术后LVSD的影响因素,使用受试者工作特征(ROC)曲线分析BNP、AngⅡ、RDW、NLR单独及联合检测对AAMI患者术后LVSD的预测价值。结果:与无LVSD组比较,LVSD组BNP[(347.52±82.66)pg/ml比(405.55±105.47)pg/ml]、AngⅡ[(238.11±20.43)ng/ml比(254.58±22.53)ng/ml]、RDW[(22.88±5.25)%比(25.52±5.58)%]、NLR[(4.34±1.09)比(5.31±1.50)]均显著升高(P均<0.01);BNP、AngⅡ、RDW、NLR均是影响AAMI患者术后LVSD的独立危险因素(OR=2.002~3.692,P<0.05或<0.01);BNP、AngⅡ、RDW、NLR联合检测对AAMI患者术后LVSD的预测价值显著高于单项检测[曲线下面积(AUC):0.809比0.650、0.696、0.641、0.694,P均<0.01]。结论:AAMI患者左心室收缩功能与BNP、AngⅡ、RDW及NLR有密切联系,上述指标联合检测可有效预测此类患者术后发生左心室收缩功能障碍。

Objective:To investigate the predictive efficacy of brain natriuretic peptide(BNP),angiotensinⅡ(AngⅡ),erythrocyte distribution width(RDW)and neutrophil/lymphocyte ratio(NLR)for postoperative left ventricular systolic dysfunction(LVSD)in patients with acute anterior myocardial infarction(AAMI).Methods:A total of 160 AAMI patients treated in our hospital from January 2018 to January 2022 were selected.According to left ventricular ejection fraction(LVEF)after percutaneous coronary intervention,they were divided into no LVSD group(LVEF>40%,n=110)and LVSD group(LVEF≤40%,n=50).Baseline data were compared between two groups.Multivariate Logistic regression analysis was used to analyze influencing factors of postoperative LVSD in AAMI patients.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of single and combined detection of BNP,AngⅡ,RDW and NLR for postoperative LVSD in AAMI patients.Results:Compared with no LVSD group,there were significant rise in levels of BNP[(347.52±82.66)pg/ml vs.(405.55±105.47)pg/ml],AngⅡ[(238.11±20.43)ng/ml vs.(254.58±22.53)ng/ml],RDW[(22.88±5.25)%vs.(25.52±5.58)%]and NLR[(4.34±1.09)vs.(5.31±1.50)]in LVSD group(P<0.01 all);BNP,AngⅡ,RDW and NLR were independent risk factors for postoperative LVSD in AAMI patients(OR=2.002~3.692,P<0.05 or<0.01);predictive value of combined detection of BNP,AngⅡ,RDW and NLR for postoperative LVSD in AAMI patients was significantly higher than those of single detection[area under the curve(AUC):0.809 vs.0.650,0.696,0.641,0.694,P<0.01 all].Conclusion:Left ventricular systolic function is closely associated with levels of BNP,AngⅡ,RDW and NLR in AAMI patients.Combined detection of the above indexes can effectively predict postoperative left ventricular systolic dysfunction in these patients.