| 喻龙姗,陈燕,吴敏,等.中性粒细胞百分比与白蛋白比值联合Gensini评分对急诊行经皮冠状动脉介入女性患者术后1年主要心血管不良事件的预测价值[J].中国临床保健杂志,2026,29(3):342-347. |
| 中性粒细胞百分比与白蛋白比值联合Gensini评分对急诊行经皮冠状动脉介入女性患者术后1年主要心血管不良事件的预测价值 |
| Predictive value of neutrophil percentage to albumin ratio combined with Gensini score for major adverse cardiac events at one year after emergency percutaneous coronary intervention in female patients with acute myocardial infarction |
| 投稿时间：2026-04-23 |
| DOI：10.3969/J.issn.1672-6790.2026.03.009 |
| 中文关键词: 心肌梗死 经皮冠状动脉介入治疗 中性粒细胞百分比 白蛋白 |
| 英文关键词: Myocardial infarction Percutaneous coronary intervention Neutrophil percentage Albumin Fund program:Anhui Provincial Health Science Research Project |
| 基金项目:安徽省卫生健康科研项目 |
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| 中文摘要: |
| 目的 探讨中性粒细胞百分比与白蛋白比值(NPAR)联合Gensini评分对女性急性心肌梗死(AMI)患者行急诊经皮冠状动脉介入治疗(PCI)术后1年发生主要心血管不良事件(MACE)的预测价值。方法 回顾性收集2021年1月1日至2024年12月31日于中国科学技术大学附属第一医院(安徽省立医院)确诊AMI并行急诊PCI治疗的女性患者的临床资料。术后随访1年,将167例患者分为MACE组(54例)和非MACE组(113例)。比较两组间基线资料、实验室检查资料及冠脉造影结果,采用单因素及多因素logistic回归分析MACE的危险因素。采用受试者操作特征(ROC)曲线评估NPAR、Gensini评分及两者联合预测的效能,并绘制决策曲线和提升曲线。结果 MACE组Gensini评分、血肌酐和NPAR水平高于非MACE组,白蛋白和血红蛋白水平低于非MACE组,组间差异有统计学意义(P<0.05)。多因素回归分析显示,NPAR≥2.093(OR=4.570,95%CI:1.006~23.494)和Gensini评分≥56分(OR=1.034,95%CI:1.021~1.049)是女性AMI患者急诊PCI术后1年MACE的独立危险因素。ROC曲线分析显示,NPAR、Gensini评分预测1年MACE的曲线下面积分别为0.680(95%CI:0.587~0.772)和0.784(95%CI:0.711~0.857),采用二元logistic回归系数的线性加权法构建NPAR和Gensini评分的联合模型,联合模型预测效能最高,AUC为0.808(95%CI:0.736~0.881),灵敏度和特异度分别为85.19%和70.80%。决策曲线和提升曲线分析均显示,在不同阈值下,NPAR联合Gensini评分对女性AMI患者急诊PCI术后1年MACE具有良好的预测能力。结论 NPAR联合Gensini评分对女性AMI患者急诊PCI术后1年MACE具有良好的预测价值且优于单一指标。 |
| 英文摘要: |
| Objective To investigate the predictive value of the neutrophil percentage to albumin ratio (NPAR) combined with the Gensini score for major adverse cardiovascular events (MACE) at 1 year after emergency percutaneous coronary intervention (PCI) in female patients with acute myocardial infarction (AMI).Methods Clinical data of female patients diagnosed with AMI and treated with emergency PCI between January 1,2021,and December 31,2024,at the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) were retrospectively collected.A total of 167 patients were stratified into the MACE group (n=54) and the non-MACE group (n=113) based on 1-year follow-up after PCI.Baseline characteristics,laboratory findings,and coronary angiography results were compared between the two groups.Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for MACE.Receiver operating characteristic (ROC) curves were used to evaluate the predictive performance of NPAR,Gensini score,and their combination.Decision and lift curves were also constructed.Results The MACE group exhibited higher Gensini scores, serum creatinine and NPAR levels,along with lower albumin and hemoglobin levels,relative to the non-MACE group (all P<0.05).Multivariate regression analysis revealed that NPAR≥2.093 (OR=4.570,95%CI:1.006-23.494) and Gensini score≥56 (OR=1.034,95%CI:1.021-1.049) were independent risk factors for 1-year MACE after emergency PCI in female AMI patients.ROC analysis showed that the areas under the curve for NPAR and Gensini score were 0.680 (95%CI:0.587-0.772) and 0.784 (95%CI:0.711-0.857),respectively.Based on the linear weighting method derived from the binary logistic regression coefficients,a combined model integrating NPAR and the Gensini score was constructed.The combined model demonstrated superior predictive performance with an AUC of 0.808 (95%CI:0.736-0.881),a sensitivity of 85.19%,and a specificity of 70.80%.Both decision and lift curve analyses demonstrated that, across different risk thresholds,the combined NPAR and Gensini score model exhibited favorable predictive ability for 1-year MACE following emergency PCI in female AMI patients.Conclusions The combination of NPAR and Gensini score provides superior predictive value for 1-year MACE after emergency PCI in female AMI patients compared to single indicators. |
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