摘要
目的探讨炎症负荷指数(IBI)与ST段抬高型心肌梗死(STEMI)患者在接受经皮冠状动脉介入(PCI)治疗后发生主要不良心血管事件(MACE)的相关性,并评估IBI对院内及长期随访期间发生MACE的预测效能。方法回顾性分析2017年12月至2021年12月在中国人民解放军联勤保障部队第九〇四医院接受PCI治疗的465例STEMI患者资料,计算每例患者的IBI。通过ROC曲线评估IBI对患者住院和长期随访期间发生MACE的预测价值,并根据最佳IBI临界值将人群分组进行临床特征分析。通过多因素logistic回归和Cox回归分析MACE的独立预测因子。通过Kaplan-Meier生存曲线和log-rank检验分析不同IBI组的MACE发生风险。结果IBI预测STEMI患者住院期间MACE的AUC值为0.687,预测长期随访期间MACE的AUC值为0.634。多因素logistic回归分析显示,高IBI(≥102.33 mg/L)的STEMI患者住院期间发生MACE的风险增加(OR=10.900,95%CI 4.273~29.180,P<0.001)。多因素Cox回归分析表明,高IBI(≥55.88 mg/L)的STEMI患者在长期随访期间发生MACE的风险增加(HR=1.989,95%CI 1.128~3.506,P=0.018)。结论IBI是STEMI患者PCI术后住院和长期随访期间发生MACE的一个有价值的预测指标。
Objective To investigate the correlation between the inflammatory burden index(IBI)and major adverse cardiovascular events(MACEs)in patients with ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI),and to assess the efficacy of IBI in predicting in-hospital and long-term MACEs.Methods This retrospective study included 465 STEMI patients who received PCI treatment in No.904 Hospital of Joint Logistics Support Force of PLA from Dec.2017 to Dec.2021.The IBI was calculated for each patient.The predictive value for in-hospital and long-term MACEs was evaluated using receiver operating characteristic(ROC)curves,and the area under curve(AUC)was calculated.The population was grouped based on the optimal IBI cut-offvalue for clinical characteristic analysis.Multivariate logistic regression and Cox regression analyses were used to identify factors independently associated with MACEs.The Kaplan-Meier estimator and log-rank test were used to assess the MACE risk of different IBI groups.Results The AUC value for predicting MACEs during hospitalization in STEMI patients using IBI was 0.687,and the AUC value for predicting long-term MACEs was 0.634.Multivariate logistic regression analysis revealed that a high IBI(≥102.33 mg/L)independently increased the risk of MACEs during hospitalization in STEMI patients(odds ratio=10.900,95%con fidence interval[95%CI]4.273-29.180,P<0.001).Multivariate Cox regression analysis further indicated that during long-term follow-up of STEMI patients,a high IBI(≥55.88 mg/L)independently predicted MACEs(hazard ratio=1.989,95%CI 1.128-3.506,P=0.018).Conclusion IBI is a valuable predictor for the occurrence of MACEs during hospitalization and long-term follow-up after PCI in STEMI patients.
作者
李一萌
徐东霞
苑日康
叶江平
周俞成
宗刚军
LI Yimeng;XU Dongxia;YUAN Rikang;YE Jiangping;ZHOU Yucheng;ZONG Gangjun(Wuxi Medical College of Jiangnan University,Wuxi 214044,Jiangsu,China;Department of Cardiology,Wuxi Clinical College of Anhui Medical University,Wuxi 214044,Jiangsu,China;The Fifth Clinical Medical College,Anhui Medical University,Hefei 230032,Anhui,China;Department of Cardiology,No.904 Hospital of Joint Logistics Support Force of PLA,Wuxi 214044,Jiangsu,China)
出处
《海军军医大学学报》
北大核心
2025年第10期1278-1289,共12页
Academic Journal of Naval Medical University
基金
中国人民解放军联勤保障部队第九〇四医院学科发展基金(XK20240203)
无锡市科技局重点课题(Y20212011).
