摘要
目的:探讨中性粒细胞百分比与白蛋白比值(NPAR)对急性ST段抬高型心肌梗死(STEMI)患者的预后预测价值。方法:回顾性分析2016-07-2017-11期间我院急诊科收治的476例STEMI患者的临床资料、实验室检查以及预后情况。根据STEMI患者入院时的NPAR三分位间距,分为A组(159例)、B组(159例)、C组(158例),采用多因素Cox回归分析STEMI患者全因死亡的独立风险因子。结果:C组比A组和B组具有更高的住院病死率(13.3%vs.3.8%vs.1.3%,P<0.01)和远期病死率(22.8%vs.5.0%vs.7.5%,P<0.01),差异均有统计学意义。Kaplan-Meier生存曲线分析显示C组累计生存率低于A组和B组(77.2%vs.95.0%vs.92.5%,P<0.01)。多因素COX回归分析显示,入院时NPAR是STEMI患者全因死亡的独立危险因素[(Avs.B)HR=4.595,95%CI:1.126~18.753,P=0.034;(Avs.C)HR=7.292,95%CI:1.926~27.610,P=0.003]。结论:在急诊早期,NPAR是预测STEMI患者死亡风险的有效工具,有助于指导临床决策。
Objective:To investigate the prognostic value of neutrophil percentage-albumin ratio(NPAR)in patients with acute ST segment elevation myocardial infarction(STEMI).Method:The clinical data,laboratory examination and prognosis of 476 STEMI patients admitted to the emergency department of West China Hospital from July 2016 to November 2017 were analyzed retrospectively.According to the triad interval of NPAR at admission,STEMI patients were divided into group A(n=159),group B(n=159)and group C(n=158).The independent risk factors of all-cause death in STEMI patients were analyzed by multivariate Cox regression.Result:Group C had higher in-hospital mortality(13.3%vs.3.8%vs.1.3%,P<0.01)and long-term mortality(22.8%vs.5.0%vs.7.5%,P<0.01)than group A and group B.Kaplan Meier survival curve analysis showed that the cumulative survival rate of group C was lower than that of group A and group B(77.2%vs.95.0%vs.92.5%,P<0.01).Multivariate Cox regression analysis showed that NPAR was an independent risk factor for all-cause death of STEMI patients[(A vs.B)HR=4.595,95%CI:1.126-18.753,P=0.034;(A vs.C)HR=7.292,95%CI:1.926-27.610,P=0.003].Conclusion:NPAR is an useful tool to predict the risk of death for STEMI patients,which is helpful to guide clinical decision-making in the early stage at emergency.
作者
张芹
程毅松
贾禹
李东泽
邹利群
高永莉
叶磊
万智
ZHANG Qin;CHENG Yisong;JIA Yu;LI Dongze;ZOU Liqun;GAO Yongli;YE Lei;WAN Zhi(Department of Emergency,West China Hospital of Sichuan University,Disaster Medical Cente of Sichuan University,Emergency and Trauma Nursing of West China Nursing College,Chengdu,610041,China)
出处
《临床急诊杂志》
CAS
2020年第5期354-358,共5页
Journal of Clinical Emergency
基金
四川省科学技术项目(No:20ZDYF2813、2019JDRC0105、2017SZ0190)
四川大学华西医院学科卓越发展1·3·5工程临床研究孵化项目(No:2018HXFH027)。
