摘要
目的:评估入院时血小板/淋巴细胞比值(PLR)、纤维蛋白原/白蛋白比值(FAR)及两者联合在冠状动脉非阻塞性心肌梗死(MINOCA)患者预后的应用价值.方法:回顾性收集2018年5月-2022年12月于沧州市人民医院诊断为MINOCA的438例患者的临床资料.根据随访期间是否发生主要不良心脑血管事件(MACCE),将患者分为MACCE组(116例)和非MACCE组(322例).采用logistic回归分析MINOCA患者预后的影响因素.运用ROC曲线评估PLR、FAR及两者联合对随访期间MACCE的预测价值.结果:两组男性占比、糖尿病占比、淋巴细胞、中性粒细胞、白蛋白、高密度脂蛋白胆固醇、尿酸、左心室射血分数、PLR及FAR比较存在显著差异(均P＜0.05).多因素logistic回归分析显示,中性粒细胞、尿酸、左心室射血分数、PLR、FAR的升高和糖尿病均为MINOCA患者MACCE的危险因素.PLR、FAR及两者联合预测MACCE的ROC曲线下面积(AUC)分别为0.656、0.691、0.762.结论:PLR和FAR是MINOCA患者MACCE的影响因素.
Abstract
Objective:The aim of this study was to evaluate the prognostic value of platelet/lymphocyte ratio(PLR),fibrinogen/albumin ratio(FAR)and their combination in patients with myocardial infarction with non-ob-structive coronary arteries(MINOCA).Methods:The clinical data of 438 patients diagnosed with MINOCA in Cangzhou People's Hospital from May 2018 to December 2022 were retrospectively collected.Patients were divid-ed into MACCE group(n=116)and non-MACCE group(n=322)according to whether major adverse cardiovas-cular and cerebrovascular events(MACCE)occurred during follow-up.Logistic regression was used to analyze the prognostic factors of MINOCA patients.ROC curve was used to evaluate the predictive value of PLR,FAR and their combination for MACCE during follow-up.Results:There were significant differences in the proportion of diabetes,lymphocytes,neutrophils,albumin,high-density lipoprotein cholesterol,uric acid,left ventricular ejec-tion fraction,PLR and FAR between the two groups(all P＜0.05).Multivariate logistic regression analysis showed that diabetes,neutrophils,uric acid,left ventricular ejection fraction,PLR and FAR were independent in-fluencing factors of MACCE in MINOCA patients.The area under the ROC curve(AUC)of PLR,FAR and their combination in predicting MACCE was 0.656,0.691 and 0.762,respectively.Conclusion:High PLR and high FAR are associated with an increased risk of MACCE in MINOCA patients,which may help to improve the clini-cal management strategy of MINOCA patients.
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