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中国医药导刊 ›› 2025, Vol. 27 ›› Issue (9): 907-911.

• 临床医药 • 上一篇    下一篇

急性心衰患者心衰易损期MACE事件发生风险与相关检验指标的关系

解晴, 郭庆, 苗黎黎   

  1. 阜阳市中医医院,安徽 阜阳 236000
  • 收稿日期:2024-12-10 修回日期:2025-08-05 接受日期:2025-09-30 出版日期:2025-09-28 发布日期:2025-11-18
  • 基金资助:
     安徽省中医药传承创新科研项目(2024CCCX176)

Relationship between the Risk of MACE during the Vulnerable Phase and Relevant Test Indexes in Patients with Acute Heart Failure

XIE Qing, GUO Qing, MIAO Lili   

  1. Fuyang Hospital of Traditional Chinese Medicine Anhui Fuyang 236000, China
  • Received:2024-12-10 Revised:2025-08-05 Accepted:2025-09-30 Online:2025-09-28 Published:2025-11-18

摘要:

目的:探究急性心力衰竭(AHF)患者心衰易损期主要心血管事件(MACE)的发生风险,分析相关检验指标对MACE的影响。方法:回顾性分析20201月至202411月我院收治的200AHF患者的临床资料,根据患者心衰易损期内MACE发生情况将57例患者纳入MACE组,143例患者纳入非MACE组。比较两组患者基线资料、实验室相关检验指标,Cox风险回归模型分析AHF患者心衰易损期MACE发生的独立危险因素,受试者工作特征曲线(ROC)对比分析不同指标对MACE发生的预测价值。结果:MACE组和非MACE组患者的年龄、心功能分级、B型利钠肽(BNP)、红细胞比容、泛免疫炎症值(PIV)比较,差异均有统计学意义(P<0.05)。多因素Cox风险回归分析结果显示,BNPHR95%CI=1.9941.293~3.075)]、红细胞比容[HR95%CI=0.4770.347~0.657)]、PIVHR95%CI=2.1921.628~2.953)]是AHF患者心衰易损期MACE发生的影响因素(P<0.05)。ROC曲线分析结果显示,BNP、红细胞比容、PIV预测MACE发生的曲线下面积(AUC)分别为0.6660.7430.746,差异均无统计学意义(P>0.05);三指标联合预测的AUC0.876,大于各单一指标(P<0.05)。结论:BNPPIV水平升高,红细胞比容降低与AHF患者心衰易损期MACE的发生风险增加有关,三者对于MACE的发生具有一定预测价值,联合应用可进一步提高预测效能。

 

关键词: 急性心力衰竭, 心衰易损期, 主要心血管事件, 泛免疫炎症值

Abstract:

Objective: To explore the risk of major adverse cardiovascular events MACE in patients with acute heart failure AHF during the vulnerable phase and analyze the impact of relevant test indexes on MACE.Methods: A retrospective analysis was conducted on the clinical data of 200 patients with AHF who were admitted to the hospital from January 2020 to November 2024. According to the occurrence of MACE during the vulnerable phase 57 patients were included in the MACE group and 143 patients were included in the non-MACE group. Baseline data and relevant laboratory test indexes of the two groups were compared. Cox hazards regression model was used to analyze the independent risk factors for MACE in patients with AHF during the vulnerable phase. Receiver operating characteristic ROC curves were used to evaluate the predictive value of different indexes for MACE.Results: There were statistically significant differences in age cardiac function classification B-type natriuretic peptide BNP), hematocrit and pan-immune inflammation value PIV between the MACE group and the non-MACE group P<0.05. Multivariate Cox hazards regression analysis showed that BNP HR 95%CI=1.994 1.293-3.075)], hematocrit HR 95%CI=0.477 0.347-0.657)] and PIV HR 95%CI=2.192 1.628-2.953)] were factors influencing the occurrence of MACE in patients with AHF during the vulnerable phase P<0.05. The areas under the curve AUCs of BNP hematocrit and PIV for predicting the occurrence of MACE were 0.666 0.743 and 0.746 without significant difference P>0.05. The AUC of joint prediction using the three indicators was 0.876 which was greater than that of each indicator P<0.05.Conclusion: Elevated BNP and PIV and decreased hematocrit are related to increased risk of MACE in patients with AHF during the vulnerable phase. The three indexes have certain predictive value for the occurrence of MACE and their combined use can further improve predictive efficacy.


Key words: Acute heart failure , Vulnerable phase in heart failure , Major adverse cardiovascular event , Pan-immune inflammation value

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