首页|基于HALP动态列线图预测ST段抬高型心肌梗死患者无复流现象风险分析

基于HALP动态列线图预测ST段抬高型心肌梗死患者无复流现象风险分析

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[目的]基于血红蛋白(Hb)、白蛋白(Alb)、淋巴细胞(LYM)和血小板(PLT)构建HALP,开发并验证动态列线图预测ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后无复流现象(NRP)风险.[方法]回顾性分析2022年1月-2024年1月南阳市中心医院收治的449例STEMI患者,根据患者术后是否发生NRP分为NRP组145例,正常复流组304例.基于Hb、Alb、LYM和PLT观测值计算HALP.通过多因素Logistic回归分析确定NRP风险的独立影响因素.使用R语言相关软件包开发STEM1患者PCI术后NRP风险的动态列线图.[结果]449例NRP患者中,NRP发生率为32.3%(145/449).NRP组患者HALP低于正常复流组患者(P<0.05),HALP诊断NRP的曲线下面积(AUC)为0.880(0.847-0.909),其最佳截断值≤3.04与真实诊断NRP患者的Kappa系数为0.612.多因素Logistic回归分析结果显示年龄、糖尿病和高敏C反应蛋白(hs-CRP)为STEMI患者PCI术后NRP的独立危险因素(P<0.05),左心室射血分数(LVEF)和HALP为独立保护因素(P<0.05).基于 HALP 结合年龄、糖尿病、LVEF 和 hs-CRP 的动态列线图(https://xz0311.shinyapps.io/DynNamicNRP/)可有效预测STEMI患者PCI术后NRP风险.[结论]HALP较传统危险因素更能有效预测STEMI患者PCI后NRP风险,而基于HALP开发出的动态列线图,将有助于开展针对高NRP风险患者的个性化治疗策略.
Risk analysis of no-reflow phenomenon in patients with ST-segment elevation myo-cardial infarction based on HALP dynamic nomogram
Aim To develop and validate a dynamic nomogram to predict the risk of no-reflow phenomenon(NRP)after percutaneous coronary intervention(PCI)in patients with ST-segment elevation myocardial infarction(STE-MI)by constructing HALP based on haemoglobin(Hb),albumin(Alb),lymphocytes(LYM),and platelets(PLT).Methods A retrospective analysis of 449 STEMI patients admitted to Nanyang Central Hospital from January 2022 to Janu-ary 2024 was divided into 145 cases in the NRP group and 304 cases in the normal reflow group according to whether the patients developed NRP after surgery.HALP was calculated based on Hb,Alb,LYM and PLT observations.Independ-ent influences on NRP risk were determined by multivariate Logistic regression analysis.Dynamic nomogram of NRP risk after PCI in STEMI patients were developed using the R language correlation software package.Results The incidence of NRP was 32.3%(145/449)among 449 patients with NRP.The HALP of patients in the NRP group was lower than that of patients in the normal reflow group(P<0.05).The area under the curve(AUC)of HALP for diagno-sis of NRP was 0.880(0.847-0.909),and the Kappa coefficient of its optimal cutoff value ≤3.04 versus patients with accurate diagnosis of NRP was 0.612.The results of multivariate Logistic regression analysis showed that age,diabetes mellitus,and high sensitivity C-reactive protein(hs-CRP)were independent risk factors for NRP after PCI in STEMI pa-tients(P<0.05),and left ventricular ejection fraction(LVEF)and HALP were independent protective factors(P<0.05).A dynamic nomogram(https://xz0311.shinyapps.io/DynNamicNRP/)based on HALP combined with age,di-abetes,LVEF,and hs-CRP was effective in predicting the risk of post-PCI NRP in STEM1 patients.Conclusion HALP is more effective than traditional risk factors in predicting NRP risk in STEMI patients after PCI,and the dynamic nomogram developed based on HALP will help develop personalized treatment strategies for patients with high NRP risk.

HALPST-segment elevation myocardial infarctionpercutaneous coronary interventionno-reflow phenomenondynamic nomogram

王星、张妍、张明磊、高建步、张永杰、齐贵彬

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南阳市中心医院,河南省南阳市 473000

HALP ST段抬高型心肌梗死 经皮冠状动脉介入治疗 无复流现象 动态列线图

2024

中国动脉硬化杂志
中国病理生理学会 南华大学

中国动脉硬化杂志

CSTPCD
影响因子:1.086
ISSN:1007-3949
年,卷(期):2024.32(11)