摘要
目的探讨酰基辅酶A合成酶长链家族成员4(ACSL4)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)及三者联合对急性失代偿性心力衰竭(ADHF)患者出院后1年内发生主要不良心血管事件(MACE)的预测价值。方法回顾性选取2020年3月—2022年12月沧州市人民医院收治的326例ADHF患者作为研究对象,根据出院后1年内MACE发生情况将患者分为无MACE组267例和MACE组59例。收集患者的临床资料,采用多因素Logistic回归分析探讨ADHF患者出院后1年内发生MACE的影响因素,绘制ROC曲线以分析ACSL4、TNF-α、CRP及三者联合对ADHF患者出院后1年内发生MACE的预测价值。结果MACE组年龄大于无MACE组,行机械通气或无创正压通气者占比及ACSL4、TNF-α、CRP高于无MACE组(P<0.05)。多因素Logistic回归分析结果显示,年龄〔OR=1.090,95%CI(1.016~1.169)〕、行机械通气或无创正压通气〔OR=20.893,95%CI(3.955~110.382)〕、ACSL4〔OR=1.016,95%CI(1.006~1.025)〕、TNF-α〔OR=1.184,95%CI(1.101~1.274)〕、CRP〔OR=3.500,95%CI(2.326~5.267)〕是ADHF患者出院后1年内发生MACE的独立影响因素(P<0.05)。ROC曲线分析结果显示,ACSL4、TNF-α、CRP及三者联合预测ADHF患者出院后1年内发生MACE的AUC分别为0.823〔95%CI(0.764~0.882)〕、0.740〔95%CI(0.670~0.810)〕、0.856〔95%CI(0.787~0.926)〕、0.930〔95%CI(0.889~0.971)〕。结论ACSL4、TNF-α、CRP是ADHF患者出院后1年内发生MACE的独立影响因素,且其对ADHF患者出院后1年内发生MACE均具有一定预测价值,而三者联合预测效能更佳。
Objective To explore the predictive value of acyl-CoA synthetase long-chain family member 4(ACSL4),tumor necrosis factor-alpha(TNF-α)and C-reactive protein(CRP)and their combination for major adverse cardiovascular events(MACE)within one-year after discharge in patients with acute decompensated heart failure(ADHF).Methods A total of 326 patients with ADHF admitted to Cangzhou People's Hospital from March 2020 to December 2022 were retrospectively selected as the research objects.According to the occurrence of MACE within one-year after discharge,the patients were divided into the non-MACE group(n=267)and the MACE group(n=59).Clinical data of patients were collected.Multivariate Logistic regression analysis was used to explore the influencing factors of MACE within one-year after discharge in ADHF patients,and ROC curve was drawn to analyze the predictive value of ACSL4,TNF-α,CRP and their combination for MACE within one-year after discharge in ADHF patients.Results Age in the MACE group was elder than that of the non-MACE group,proportion of patients with mechanical ventilation or noninvasive positive pressure ventilation,ACSL4,TNF-α,and CRP were higher than those of the non-MACE group(P<0.05).Multivariate Logistic regression analysis showed that,age[OR=1.090,95%CI(1.016-1.169)],mechanical ventilation or noninvasive positive pressure ventilation[OR=20.893,95%CI(3.955-110.382)],ACSL4[OR=1.016,95%CI(1.006-1.025)],TNF-α[OR=1.184,95%CI(1.101-1.274)]and CRP[OR=3.500,95%CI(2.326-5.267)]were independent influencing factors for MACE within one-year after discharge in ADHF patients(P<0.05).ROC curve analysis showed that,the AUC of ACSL4,TNF-α,CRP and their combination in predicting MACE within one-year after discharge in ADHF patients was 0.823[95%CI(0.764-0.882)],0.740[95%CI(0.670-0.810)],0.856[95%CI(0.787-0.926)],and 0.930[95%CI(0.889-0.971)],respectively.Conclusion ACSL4,TNF-αand CRP are independent influencing factors for MACE within one-year after discharge in ADHF patients,and they have a certain predictive va
作者
钟昊
刘占豪
袁雪
张芳芳
侯晓华
ZHONG Hao;LIU Zhanhao;YUAN Xue;ZHANG Fangfang;HOU Xiaohua(Department of Cardiac Surgery,Cangzhou People's Hospital,Cangzhou 061000,China;Department of Thoracic Surgery,Cangzhou People's Hospital,Cangzhou 061000,China;Department of Orthopaedics,Renqiu Hospital of Traditional Chinese Medicine,Renqiu 062550,China;Department of Sensory and Control,Raoyang County People's Hospital,Hengshui 053900,China)
出处
《实用心脑肺血管病杂志》
2024年第12期17-21,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
河北省2022年度医学科学研究课题计划(20220304)。
