| 张询,许敏,文俊杰.急性心肌梗死住院期间新发心房颤动的风险因素及 TIMI危险评分、 CA-125、NT-proBNP对其预测价值研究[J].安徽医药,2025,29(8):1660-1664. |
| 急性心肌梗死住院期间新发心房颤动的风险因素及 TIMI危险评分、 CA-125、NT-proBNP对其预测价值研究 |
| Study on the risk factors of new AF in AMI during hospitalization and the predictive value of score of TIMI risk, CA-125 and NT-proBNP |
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| DOI：10.3969/j.issn.1009-6469.2025.08.036 |
| 中文关键词: 心肌梗死 心房颤动 危险因素 心肌梗死溶栓危险评分 癌胚抗原 -125 氨基末端脑钠尿肽前体 ROC曲线 |
| 英文关键词: Myocardial infarction Atrial fibrillation Risk factors Thrombolysis in myocardial infarction Carcinoembryonic antigen-125 Amino-terminal brain natriuretic peptide precursor |
| 基金项目:四川省科技成果转移转化项目( 2021ZYZFSY01) |
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| 中文摘要: |
| 目的分析急性心肌梗死( AMI)住院期间新发心房颤动( AF)的风险因素及心肌梗死溶栓( TIMI)危险评分、癌胚抗原 -125(CA-125)、氨基末端脑钠尿肽前体( NT-proBNP)对其预测价值研究。方法将 2021年 1月至 2022年 12月广安市人民医院心血管内科收治的 AMI病人 302例纳入研究，根据住院期间新发 AF情况将病人分为新发 AF组( 80例)和未新发 AF组( 222例)回顾性收集其临床资料。通过单因素及多因素分析法分析 AMI住院期间新发 AF的风险因素，将新发 AF纳入阳性，未新发 AF纳，入阴性， TIMI危险评分、 CA-125、NT-proBNP在的 AMI住院期间新发 AF的预测价值通过受试者操作特征曲线( ROC曲线)完成。结果新发 AF组年龄 >60岁、左心室射血分数( LVEF)≤50%比例， TIMI危险评分［(8.20±2.36)分比(5.64±1.77)分］，血清 CA-125［(51.10±8.42)U/mL比( 43.53±9.45)U/mL］、 NT-proBNP［( 1 536.86±169.35)mmol/L比( 1 312.72±191.59)mmol/L］、细胞介素 -6(IL-6)、肿瘤坏死因子 α(TNF-α)、超敏 C反应蛋白( hs-CRP)水平高于未新发 AF组( P<0.05)。多因素 logistic分析结白果显示，年龄 >60岁、左心室射血分数( LVEF)≤50%，TIMI危险评分升高、血清 CA-125水平升高、血清 NT-proBNP水平升高为 AMI住院期间新发 AF的危险因素( P<0.05)。将 AMI住院期间新发 AF纳入阳性， AMI未新发 AF为阴性， ROC曲线结果表明， TIMI危险评分、 CA-125、NT-proBNP、联合检测预测 AMI住院期间新发 AF的曲线下面积( AUC)分别为 0.67、0.63、0.68、0.77，联合检测与其他指标的 AUC相比，均为最高，与 TIMI危险评分比较( Z=2.30，P=0.022)，与 CA-125比较( Z=2.98，P=0.003)；与 NT-proBNP比较( Z=1.97，P=0.048)。结论 AMI住院期间新发 AF的危险因素较多，联合 TIMI危险评分， CA-125、NT-proBNP更有助于评估 AMI住院期间新发 AF的风险，可为 AMI住院期间新发 AF的预防策略制定提供依据，进而降低其发生风险，改善病人预后。 |
| 英文摘要: |
| Objective To analyze the risk factors of new atrial fibrillation (AF) in acute myocardial infarction (AMI) during hospital-ization and the predictive value of score of thrombolysis in myocardial infarction (TIMI) risk, carcinoembryonic antigen-125 (CA-125) and amino-terminal brain natriuretic peptide precursor (NT-proBNP).Methods A total of 302 patients with AMI admitted to Depart-ment of Cardiovascular Medicine of Guang'an People's Hospital from January 2021 to December 2022 were included in the study.Based on the occurrence of new AF during hospitalization, the patients were assigned into the new AF group (80 cases) and the withoutnew AF group (222 cases), and their clinical data were retrospectively collected. The risk factors of new AF in AMI were analyzed byunifactor and multifactor analysis, and the new AF during hospitalization was included as positive, while the non-new AF during hospi-talization was included as negative. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of score ofTIMI risk, CA-125, NT-proBNP alone and combined detection for new AF during hospitalization in AMI.Results The proportion of the new-onset AF group aged > 60 years, left ventricular ejection fraction (LVEF) ≤ 50%, TIMI risk score [(8.20±2.36) vs. (5.64±1.77)], serum CA-125 [(51.10±8.42) U/mL vs. (43.53±9.45) U/mL], NT-proBNP [(1 536.86±169.35) mmol/L vs. (1 312.72±191.59) mmol/L], IL-6, TNF-α, and hs-CRP levels were higher than those of the non-new-onset AF group (P < 0.05). Multivariate logistic analysis showedthat age > 60 years old, left ventricular ejection fraction (LVEF) ≤ 50%, increased score of TIMI risk, increased serum level of CA-125, increased serum level of NT-proBNP were the risk factors for new AF during hospitalization in AMI (P < 0.05). The results of ROC curve showed that the area under the curve (AUC) predicted by score of TIMI risk, CA-125, NT-proBNP and combined detection was0.67, 0.63, 0.68, 0.77 for new AF during hospitalization of AMI, respectively. The AUC of the remaining indicators was the highest,compared with score of TIMI risk (Z = 2.30, P = 0.022) and CA-125 risk (Z = 2.98, P = 0.003), cmparison with NT-proBNP (Z = 1.97, P = 0.048).Conclusion There are many risk factors for new-onset AF in AMI, the combined detection of score of TIMI risk, CA-125 and NT-proBNP are more helpful in assessing the risk of new atrial fibrillation during hospitalization for AMI, so as to reduce its riskand improve the prognosis of patients. |
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