血清RBP4联合全身免疫炎症指数对急性冠状动脉综合征患者介入术后主要心血管不良事件的预测价值

Predictive Value of Serum RBP4 Combined with Systemic Immune-Inflammation Index for Major Adverse Cardiovascular Events After Intervention in Patients with Acute Coronary Syndrome

目的 研究血清视黄醇结合蛋白4(RBP4)联合全身免疫炎症指数(SII)对急性冠状动脉综合征(ACS)患者介入术后主要心血管不良事件(MACE)的预测价值。方法 选取2021年3月至2023年10月在重庆市云阳县人民医院接受介入术的ACS患者152例(ACS组),根据介入术后6个月是否发生MACE分为MACE组(32例)和非MACE组(120例),另选取同期57名健康体检志愿者(对照组)。收集ACS患者临床资料,检测ACS组和对照组血清RBP4水平,并计算SII。分析ACS患者介入术后MACE的影响因素和血清RBP4、SII对其的预测价值。结果 ACS组血清RBP4水平和SII明显高于对照组(P <0.05)。年龄增加、急性心肌梗死、Killip分级≥Ⅱ级、RBP4升高、SII升高为ACS患者介入术后MACE的独立危险因素(P <0.05),左心室射血分数升高为其独立保护因素(P <0.05)。血清RBP4水平联合SII预测ACS患者介入术后MACE的曲线下面积为0.833,大于RBP4、SII单独预测的0.744、0.750(P <0.05)。结论血清RBP4水平联合SII对预测ACS患者介入术后MACE的价值较高,且对预后的评估具有一定指导意义。

Objective To investigate the predictive value of serum retinol-binding protein 4(RBP4)combined with the systemic immunoinflammatory index(SII)for major adverse cardiovascular events(MACE)after intervention in patients with acute coronary syndrome(ACS).Methods A total of 152 patients with ACS who underwent intervention at Yunyang County People's Hospital between March 2021 and October 2023(ACS group)were enrolled and divided into the MACE group(32 patients)and non-MACE group(120 patients)based on the occurrence of MACE within 6 months after intervention.Additionally,57 healthy volunteers who underwent health checkups during the same period were selected as the control group.Clinical data of the ACS patients were collected,serum RBP4 levels were measured,and the SII was calculated.Factors associated with post-interventional MACE in ACS patients and the predictive value of serum RBP4 and SII were analyzed.Results Serum RBP4 levels and SII were significantly higher in the ACS group compared to the control group(P<0.05).Increased age,acute myocardial infarction,KILLIP classification≥class II,elevated RBP4,and elevated SII were identified as independent risk factors for MACE after intervention in patients with ACS(P<0.05).Conversely,an elevated left ventricular ejection fraction was an independent protective factor against MACE(P<0.05).The area under the curve(AUC)for predicting post-interventional MACE in ACS patients based on serum RBP4 levels combined with SII was 0.833,which was higher than the AUCs of 0.744 and 0.750 predicted by RBP4 and SII alone,respectively(P<0.05).Conclusion Serum RBP4 levels combined with SII exhibited high value in predicting MACE after intervention in ACS patients and had certain guiding significance for prognosis assessment.