摘要
目的探究与分析急诊经皮冠状动脉介入(PCI)术后营养控制状态(CONUT)评分预测近期主要不良心脑血管事件的应用价值.方法回顾性分析我院自2020年2月至2021年1月收治的108例年龄在65岁以上急诊PCI患者的临床资料,全部患者均采用了CONUT评分判断其营养状态,并在术后对其进行1年的随访记录,将发生主要不良心脑血管事件的患者21例作为观察组,其余未发生主要不良心脑血管事件的患者87例作为对照组,对比两组患者的临床资料,同时按照CONUT评分将患者按照营养状态分组,统计不同营养状态下患者主要不良心脑血管事件的发生率,利用ROC曲线分析急诊PCI术后CONUT评分在近期主要不良心脑血管事件的应用价值,CONUT营养状态与死亡事件的关系用Kaplan-Meier法绘制生存曲线.结果观察组与对照组患者年龄、体质指数、并发症发生情况、吸烟史患者比例、心率、空腹血糖水平、CONUT评分、GRACE评分、左心室射血分数相比,差异均有统计学意义(P<0.05).重度营养不良组分别与中度营养不良组、轻度营养不良组、正常组相比主要不良事件发生率较高,中度营养不良组分别与轻度营养不良组、正常组相比主要不良事件发生率较高,轻度营养不良组与正常组相比主要不良事件发生率较高,差异均有统计学意义(P<0.05).行ROC曲线分析可见,采用CONUT评分预测急诊PCI术后主要不良心脑血管事件发生的预测价值可见,曲线下面积(AUC)为0.880(95%CI:0.796~0.965),当切点值在4.5时,此时敏感度及特异度分别为86.1%和50.00%.COUNT低分组与COUNT高分组相比生存率明显较高,差异有统计学意义(P<0.05).结论急诊PCI术后CONUT评分预测近期主要不良心脑血管事件中的应用价值较高,可为接下来的预后判断提供可靠的参考依据.
Objective To explore and analyze the application value of nutritional control status(CONUT)score in predicting short term major adverse cardiovascular and cerebrovascular events after emergency percuta-neous coronary intervention(PCI)surgery.Methods The clinical data of 108 patients aged over 65 years who underwent emergency PCI in our hospital from February 2020 to January 2021 were retrospectively analyzed.All patients were judged by CONUT score to determine their nutritional status,and were followed up for 1 year after surgery.Twenty-one patients with major adverse cardiovascular and cerebrovascular events were assigned to the observation group,and the remaining 87 patients without major adverse cardiovascular and cerebrovascular events were assigned to the control group.Results There were significant differences in age,BMI,complications,pro-portion of patients with smoking history,heart rate,fasting blood glucose level,CONUT score,GRACE score,left ventricular ejection fraction between the observation group and the control group(P<0.05).The incidence of major adverse events was higher in the severe malnutrition group than in the moderate malnutrition group,the mild malnutrition group,and the normal group.The incidence of major adverse events was higher in the moderate malnutrition group than in the mild malnutrition group and the normal group.And the incidence of major adverse events was higher in the mild malnutrition group than in the nor-mal group,with statistically significant differences(P<0.05).ROC curve analysis showed that the predictive value of CONUT score in predicting the occurrence of major adverse cardiovascular and cerebrovascular events after emer-gency PCI was significant,with an area under the curve(AUC)of 0.880(95%CI:0.796~0.965).When the cut-offvalue was 4.5,the sensitivity and specificity were 86.1%and 50.00%,respectively.The survival rate of the low COUNT group was significantly higher than that of the high COUNT group,with statistically significant differences(P<0.05).Conclusion Th
作者
高宏伟
GAO Hongwei(Department of Geriatrics,Linyi Dongshan Hospital,Linyi 276017,China)
出处
《中华灾害救援医学》
2024年第1期53-56,64,共5页
Chinese Journal of Disaster Medicine
