摘要
目的:探讨非ST段抬高型心肌梗死(non-ST-segment elevation myocardial infarction,NSTEMI)患者的营养状态与近期及远期主要心血管不良事件(major adverse cardiovascular events,MACE)发生的相关性。方法:连续收集2012年8月至2020年3月,在新疆医科大学第一附属医院心脏中心就诊的731例NSTEMI患者。营养状况评估采用:老年营养风险指数(geriatric nutritionalrisk index, GNRI)、预后营养指数(prognosis nutritional index, PNI)、控制营养状态评分(controlling nutritional status, CONUT)、尼泊尔评分(naples prognostic score, NPS)。单因素和多因素Logistic回归分析来确定不同营养指标与近期MACE发生的相关性;采用Cox比例风险回归分析营养指标与远期MACE的关系。采用Kaplan-Meier生存分析比较不同营养评分患者远期生存率的差异。结果:731例NSTEMI患者中,有49例发生近期MACE事件。单因素及多因素Logistic回归分析结果表明:GNRI、PNI、CONUT评分与NSTEMI患者发生近期MACE有相关性。剩余患者进行36个月的随访,其中146例患者发生远期MACE事件。单因素及多因素Cox回归分析表明,GNRI和CONUT与NSTEMI患者远期MACE的发生相关。Kaplan-Meier生存分析显示低GNRI组患者的远期MACE事件发生率高于高GNRI组(Log-rank,P<0.001)。结论:GNRI评分、CONUT评分与NSTEMI患者近期及远期MACE事件的发生相关,且GNRI评分预测价值优于CONUT评分。
Objective:To investigate the correlation between nutritional status and the incidence of recent and long-term major adverse cardiovascular events(MACE)events in patients with non-ST-segment elevation myocardial infarction(NSTEMI).Methods:A total of 731 patients with NSTEMI who attended the Heart Center of the First Affiliated Hospital of Xinjiang Medical University from August 2012 to March 2020 were continuously collected.Nutritional status assessment was assessed using the geriatric nutritionalrisk index(GNRI),prognosis nutritional index(PNI),controlling nutritional status(CONUT),and naples prognostic score (NPS).Univariate and multivariate logistic regression analysis to determine the correlation between different nutritional indicators and recent MACE occurrence;Cox proportional risk regression was used to analyze the relationship between nutritional indicators and long-term MACE.Kaplan-Meier survival analysis was used to compare the differences in long-term survival between patients with different nutritional scores.Results:Of the 731 patients with NSTEMI,49 had a recent MACE event.Univariate and multivariate logistic regression results showed that GNRI,PNI and CONUT scores correlated with recent MACE in NSTEMI patients.The remaining patients were followed for 36 months,and 146 of them developed a long-term MACE event.Univariate and multivariate Cox regression analysis showed that GNRI and CONUT were associated with the occurrence of long-term MACE in NSTEMI patients.Kaplan-Meier survival analysis showed that patients in the low GNRI group had a higher incidence of long-term MACE events than those in the high GNRI group(Log-rank,P<0.001).Conclusion:GNRI score and CONUT score are correlated with the occurrence of recent and long-term MACE events in patients with NSTEMI,and the predictive value of GNRI score is better than that of CONUT score.
作者
张志扬
张雪鹤
刘芬
宋宁
杨毅宁
李晓梅
ZHANG Zhiyang;ZHANG Xuehe;LIU Fen;SONG Ning;YANG Yining;LI Xiaomei(Depatment of Heart Center,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830001,China)
出处
《心肺血管病杂志》
CAS
2023年第8期776-782,共7页
Journal of Cardiovascular and Pulmonary Diseases
基金
国家自然科学基金项目(8216020109)
新疆维吾尔自治区重点研发项目(2020B03002-1)
新疆维吾尔自治区研究生科研创新项目(XJ2022G158)。
关键词
营养评分
非ST段抬高型心肌梗死
不良心血管事件
Nutritional score
Non ST segment elevation myocardial infarction
Adverse cardiovascular events
