| 姬燕,杨荣礼.老年营养风险指数对非 ST段抬高型急性冠状动脉综合征病人经皮冠状动脉介入术后院内主要心血管不良事件的预测价值[J].安徽医药,2023,27(6):1224-1227. |
| 老年营养风险指数对非 ST段抬高型急性冠状动脉综合征病人经皮冠状动脉介入术后院内主要心血管不良事件的预测价值 |
| Predictive value of the Geriatric Nutritional Risk Index for in-hospital major adverse cardiovascular events after PCI in patients with NSTE-ACS |
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| DOI：10.3969/j.issn.10096469.2023.06.038 |
| 中文关键词: 急性冠状动脉综合征 老年营养风险营养指数 全球急性冠状动脉事件注册积分 心血管不良事件 经皮冠状动脉介入术 血清白蛋白 |
| 英文关键词: Acute coronary syndrome Geriatric nutrition risk index Global acute coronary event registry score Adverse cardiovascular events Percutaneous coronary intervention Serum albumin |
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| 中文摘要: |
| 目的探讨老年营养风险营养指数( GNRI)对非 ST段抬高型急性冠状动脉综合征( NSTE-ACS)病人经皮冠状动脉介入术( PCI)后发生院内主要心血管不良事件( MACE)的预测价值。方法回顾性收集 2019年 12月至 2021年 6月徐州医科大学附属医院收治的经 PCI治疗的 NSTE-ACS病人 360例，根据病人术后是否发生 MACE，分为 MACE组 48例和非 MACE组 312例。比较两组间临床资料、实验室检查结果的区别。应用多因素 logistic回归分析评估发生 MACE的危险因素。应用受试者操作特征( ROC)曲线及 Delong检验评估 GNRI，全球急性冠状动脉事件注册积分( Grace评分)对 MACE的预测价值及差异。结与非 MACE组相比， MACE组年龄( 75.50±5.37)岁、 Grace评分( 168.00±32.50)分显著高于非 MACE组( 69.95±5.21)岁、(1果39.02±22.59)分， GNRI(95.97±7.33)显著低于非 MACE组( 103.75±10.47)(P<0.05)。多因素 logistic回归分析显示，低 GNRI、 Grace评分增加及年龄增加是 NSTE-ACS病人发生 MACE的危险因素(均 P<0.05)。 ROC分析显示， GNRI、Grace评分和两者联合预测 MACE发生的曲线下面积分别为 0.74、0.77、0.81(均 P<0.05)。进一步使用 Delong检验对 GNRI及 Grace评分的 ROC曲线进行比较，结果显示差异无统计学意义( Z=0.73，P=0.468)。结论 GNRI是发生院内 MACE的重要影响因素，术前 GNRI水平对 NSTE-ACS病人 PCI术后发生院内 MACE具有一定的预测价值。 |
| 英文摘要: |
| Objective To investigate the predictive value of the geriatric nutritional risk index (GNRI) on the occurrence of in-hospital major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS).Methods A total of 360 patients with NSTE-ACS treated by PCI admitted to the AffiliatedHospital of Xuzhou Medical University from December 2019 to June 2021 were retrospectively collected and divided into the MACEgroup (n=48) and the non-MACE group (n=312) according to whether the patients had MACE after the procedure. The differences inclinical data and laboratory test results were compared between the two groups. Multivariate logistic regression analysis was applied toevaluate the risk factors for the occurrence of MACE. Receiver operating characteristic (ROC) curve and Delong method were used toevaluate the predictive value and difference of GNRI, Global Registry of Acute Coronary Events score (Grace score) on MACE.Results Compared with the non-MACE group, the MACE group had a significantly higher age (75.50±5.37) and Grace score (168.00±32.50) than the non-MACE group (69.95±5.21 and 139.02±22.59, respectively) and a significantly lower GNRI (95.97±7.33) than the non-MACE group (103.75±10.47) (P<0.05). Multivariate logistic regression analysis showed that low GNRI, increasing GRACE score and increasing age were risk factors for the development of MACE in patients with NSTE-ACS (P<0.05). ROC analysis showed that the area under the curve for the GNRI, GRACE score and both combined to predict the occurrence of MACE was 0.74, 0.77, and 0.81 (P<0.05), respectively. Further comparison of the ROC curves for the GNRI and Grace score using the Delong method showed no statistically significant difference (Z=0.73, P=0.468).Conclusion The GNRI is an important influencing factor for the occurrence of in-hospital MACE,and the preoperative GNRI level has predictive value for the occurrence of in-hospital MACE after PCI in patients with NSTE-ACS. |
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