摘要
目的探讨CHA_(2)DS_(2)-VASc评分与生物标志物对急性心肌梗死(AMI)猝死风险评估的应用价值。方法选择2021年1月至2022年8月我院急救中心治疗的AMI患者500例,根据住院期间及出院后3个月内随访结果分为猝死组34例和非猝死组466例。收集患者一般临床资料,C反应蛋白、血小板计数、肌酸激酶同工酶(CK-MB)、肌钙蛋白I、D-二聚体、中性粒细胞、N末端B型钠尿肽前体(NT-proBNP)、人可溶性凝集素样氧化低密度脂蛋白受体1(sLOX-1)等,构建AMI患者猝死预测,采用Hosmer-Lemeshow检验模型的拟合度。结果猝死组年龄>70岁、体质量指数(BMI)≥20 kg/m^(2)、C反应蛋白、血小板计数、CK-MB、D-二聚体、中性粒细胞、NT-proBNP、sLOX-1、CHA_(2)DS_(2)-VASc评分较非猝死组明显升高(P<0.05,P<0.01)。BMI、CK-MB、NT-proBNP、sLOX-1、CHA_(2)DS_(2)-VASc评分是AMI患者猝死的独立影响因素(P<0.05,P<0.01)。模型拟合优度较好(χ^(2)=3.505,P=0.899),AMI患者猝死的预测模型准确性为93.6%。结论BMI、生物学标志物CK-MB、NT-proBNP、sLOX-1以及CHA_(2)DS_(2)-VASc评分构建的预测模式对AMI患者猝死具有较高的预测准确性。
Objective To explore the application value of CHA_(2)DS_(2)-VASc score and biomarkers in the risk assessment of sudden death in AMI.Methods A total of 500 AMI patients admitted in our emergency center from January 2021 to August 2022 were recruited,and then divided into sudden death group(34 cases)and non-sudden death group(466 cases)according to the follow-up outcomes.Their general clinical data,neutrophil and platelet counts,and levels of CRP,CK-MB,cTnI,D-dimer,NT-proBNP,human sLOX-1 and other biomarkers were collected.The prediction model of sudden death in AMI patients was constructed and the fit of the model was studied by Hosmer-Lemeshow test.Results The sudden death group had larger proportions of age of 70 years and BMI≥20 kg/m^(2),higher platelet and neutrophil counts,increased levels of CRP,CK-MB,D-dimer,NT-proBNP and sLOX-1,and raised CHA_(2)DS_(2)-VASc score than the non-sudden death group(P<0.05,P<0.01).BMI,CK-MB,NT-proBNP,sLOX-1 and CHA_(2)DS_(2)-VASc score were independent influencing factors of sudden death in AMI patients(P<0.05,P<0.01).The prediction model of sudden death in AMI patients had a good fit(χ^(2)=3.505,P=0.899),with an accuracy of 93.6%.Conclusion The prediction model of BMI,CK-MB,NT-proBNP,sLOX-1 and CHA_(2)DS_(2)-VASc score has high prediction accuracy for sudden death in patients with AMI.
作者
陈红伟
曹军
王志方
李树斌
何文龙
张继伟
任俊燕
Chen Hongwei;Cao Jun;Wang Zhifang;Li Shubin;He Wenlong;Zhang Jiwei;Ren Junyan(Emergency Center,Xinziang Central Hospial,Fourth Clinical School of XinziangMedical College,Xinziang 453000,Henan Province,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2023年第8期823-826,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
河南省医学科技攻关计划项目(LHGJ20210907)。
关键词
心肌梗死
猝死
心脏
风险评估与减低
预测
myocardial infarction
death,sudden,cardiac
risk evaluation and mitigation
prediction
