摘要
目的观察系统免疫炎症指数(SII)、N末端脑利钠肽前体(NT-proBNP)、左心室射血分数(LVEF)对射血分数降低型心力衰竭(HFrEF)患者发生主要心血管不良事件(MACE)的预测效能。方法HFrEF患者210例,根据随访期间MACE发生情况分为MACE组67例和非MACE组143例。收集两组患者的一般资料进行倾向性评分匹配法(PSM)匹配,得到58对组间变量均衡样本,即MACE组58例和非MACE组58例进行后续研究。收集并比较PSM匹配后两组患者的临床资料,包括空腹血糖、血红蛋白、SII、肌钙蛋白、NT-proBNP、血肌酐、尿素氮、LVEF等;采用多因素Cox回归模型分析HFrEF患者发生MACE的影响因素,采用受试者工作特征(ROC)曲线分析各影响因素对HFrEF患者发生MACE的预测效能。结果PSM匹配后MACE组SII、肌钙蛋白、NT-proBNP水平高于非MACE组(P均<0.05),LVEF水平低于非MACE组(P<0.05)。多因素Cox回归分析结果显示,SII、NT-proBNP、LVEF是HFrEF患者发生MACE的独立影响因素(P均<0.05)。SII预测HFrEF患者发生MACE的曲线下面积(AUC)为0.829,灵敏度为0.881、特异度为0.811;NT-proBNP预测HFrEF患者发生MACE的AUC为0.780,灵敏度为0.776、特异度为0.804;LVEF预测HFrEF患者发生MACE的AUC为0.782,灵敏度为0.821、特异度为0.811;SII、NT-proBNP、LVEF三者联合预测HFrEF患者发生MACE的AUC为0.902,灵敏度为0.970、特异度为0.783。结论SII、NT-proBNP、LVEF是HFrEF患者发生MACE的独立影响因素,三者联合对HFrEF患者发生MACE的预测效能较高。
Objective To evaluate the predictive value of the systemic immune-inflammation index(SII),N-termi⁃nal pro-brain natriuretic peptide(NT-proBNP),and left ventricular ejection fraction(LVEF)for major adverse cardiovas⁃cular events(MACE)in patients with heart failure with reduced ejection fraction(HFrEF).Methods A total of 210 HFrEF patients were included and divided into the MACE group(67 cases)and non-MACE group(143 cases)based on the occurrence of MACE during follow-up.General data from both groups were collected and balanced using propensity score matching(PSM),resulting in 58 matched pairs(58 cases in the MACE group and 58 in the non-MACE group)for subsequent analysis.Clinical data,including fasting blood glucose,hemoglobin,SII,troponin,NT-proBNP,serum creat⁃inine,blood urea nitrogen,and LVEF,were collected and compared between the two groups after PSM.Multivariate Cox regression analysis was used to identify factors influencing MACE in HFrEF patients,and receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive performance of these factors.Results After PSM,the MACE group had significantly higher levels of SII,troponin,and NT-proBNP,and a lower level of LVEF than the non-MACE group(all P<0.05).Multivariate Cox regression analysis indicated that SII,NT-proBNP,and LVEF were independent predictors of MACE in HFrEF patients(all P<0.05).The area under the ROC curve(AUC)for SII in predicting MACE was 0.829,with a sensitivity of 0.881 and specificity of 0.811.The AUC for NT-proBNP was 0.780,with a sensi⁃tivity of 0.776 and specificity of 0.804.The AUC for LVEF was 0.782,with a sensitivity of 0.821 and specificity of 0.811.The combined prediction model of SII,NT-proBNP,and LVEF achieved an AUC of 0.902,with a sensitivity of 0.970 and specificity of 0.783.Conclusions SII,NT-proBNP,and LVEF are independent predictors of MACE in HFrEF patients.The combination of these three markers demonstrates high predictive efficacy for MACE in this patient population.
作者
汪菲
李银
黎敬锋
WANG Fei;LI Yin;LI Jingfeng(The Fourth Department of Cardiology,The Affiliated Chuzhou Hospital of Anhui Medical University(The First People’s Hospital of Chuzhou),Chuzhou 239000,China)
出处
《山东医药》
2026年第1期79-83,共5页
Shandong Medical Journal
基金
安徽省卫生健康委科研项目(AHWJ2021b0030)。
关键词
系统免疫炎症指数
N末端脑利钠肽前体
左心室射血分数
射血分数降低型心力衰竭
主要心血管不良事件
倾向性评分匹配法
systemic immune-inflammation index
N-terminal pro-brain natriuretic peptide
left ventricular ejec⁃tion fraction
heart failure with reduced ejection fraction
major adverse cardiovascular events
propensity score matching
