[1]马晓雨,潘思雨,李若水,等.Glasgow预后评分、C反应蛋白/白蛋白与全球急性冠状动脉登记事件评分对急性非ST段抬高型心肌梗死患者PCI术后院内不良预后的预测价值[J].陕西医学杂志,2025,54(10):1343-1348.[doi:DOI:10.3969/j.issn.1000-7377.2025.10.008]
　MA Xiaoyu,PAN Siyu,LI Ruoshui,et al.Predictive value of glasgow prognostic score,C-Reactive protein/Albumin,and GRACE score for adverse in-hospital prognosis after PCI in patients with acute Non-ST-Segment elevation myocardial infarction[J].,2025,54(10):1343-1348.[doi:DOI:10.3969/j.issn.1000-7377.2025.10.008]
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Glasgow预后评分、C反应蛋白/白蛋白与全球急性冠状动脉登记事件评分对急性非ST段抬高型心肌梗死患者PCI术后院内不良预后的预测价值

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
54
期数:
2025年10期
页码:
1343-1348
栏目:
临床研究
出版日期:
2025-10-05

文章信息/Info

Title:
Predictive value of glasgow prognostic score,C-Reactive protein/Albumin,and GRACE score for adverse in-hospital prognosis after PCI in patients with acute Non-ST-Segment elevation myocardial infarction
作者:
马晓雨; 潘思雨; 李若水; 纵静; 钱文浩
（徐州医科大学附属医院心内科，江苏 徐州 221000）
Author(s):
MA Xiaoyu; PAN Siyu; LI Ruoshui; ZONG Jing; QIAN Wenhao
(Department of Cardiology,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)
关键词:
Glasgow预后评分; C反应蛋白/白蛋白; GRACE评分; 急性非ST段抬高型心肌梗死; 主要心血管不良事件; 预测
Keywords:
Glasgow prognostic score; C-reactive protein/Albumin; GRACE score; Acute non-ST-segment elevation myocardial infarction; Major adverse cardiovascular events; Prediction
分类号:
R 541.4
DOI:
DOI:10.3969/j.issn.1000-7377.2025.10.008
文献标志码:
A
摘要:
目的：评估Glasgow预后评分（GPS）、C反应蛋白与白蛋白比值（CAR）、全球急性冠脉登记事件评分（GRACE）在预测急性非ST段抬高型心梗（NSTEMI）患者住院期间主要心血管不良事件（MACE）方面的作用。方法：选取293例NSTEMI患者，依据治疗后是否发生MACE分为两组，其中MACE组56例，非MACE组237例。根据患者临床资料及检验数据，计算得出GPS、CAR及GRACE评分。运用二元Logistic回归探究影响 MACE 发生的因素，采用受试者工作特征（ROC）曲线对比 GPS、CAR 及 GRACE 评分对 MACE 发生的预测效能。应用二元Log-binomial回归模型进行不同GRACE 评分、GPS、CAR与MACE的亚组分析。结果：共纳入293例行急诊冠状动脉介入术（PCI）的NSTEMI患者。年龄、吸烟情况、GRACE评分、GPS及CAR是MACE发生的独立影响要素。ROC曲线分析表明，三者对MACE发生均具一定预测效能，GPS的曲线下面积（AUC）为0.721（95%CI:0.642~0.800）高于CAR[AUC=0.672（95%CI:0.586~0.757）]，并与GRACE评分（AUC=0.729，95%CI:0.651~0.807）相近。三者联合AUC最大为0.818（95%CI:0.752~0.884)，灵敏度和特异度分别为 67.90%、84.00%。根据3分位数法将GRACE 评分、GPS、CAR均分为三组（Q1~Q3），Q1、Q2组、Q3组的MACE的发生率比较具有统计学意义（均P＜0.05），Q2组、Q3组发生MACE的风险均高于Q1组（均P<0.001）。结论：GPS和CAR均是NSTEMI院内MACE发生的独立危险因素，联合GEACE评分后，可提升其预测效能。
Abstract:
Objective:Evaluate the predictive value of Glasgow Prognostic Score (GPS),C-reactive protein/albumin (CAR),and Global Acute Coronary Event Registry (GRACE) score for major cardiovascular adverse events (MACE) in patients with acute non ST segment elevation myocardial infarction (NSTEMI).Methods：293 NSTEMI patients who underwent percutaneous coronary intervention (PCI) were divided into MACE group (n=56) and non MACE group (n=237).Calculate GPS,CAR,and GRACE scores based on patient clinical data and laboratory test data.Using binary logistic regression to analyze the influencing factors of MACE occurrence,and comparing the predictive value of GPS,CAR,and GRACE scores for MACE occurrence through receiver operating characteristic (ROC) curve analysis.Perform subgroup analysis of different GRACE scores,GPS,CAR,and MACE using a binary log genomic regression model.Results:A total of 293 NSTEMI patients who underwent emergency PCI were included.Age,smoking history,GRACE score,GPS,and CAR are independent influencing factors for the occurrence of MACE.The ROC curve analysis results showed that all three have certain predictive value for the occurrence of MACE.The area under the curve (AUC) of GPS was 0.721(95%CI:0.642-0.800),higher than CAR [AUC=0.672 (95%CI:0.586-0.757)],and similar to GRACE score (AUC=0.729,95%CI:0.651-0.807).The maximum combined AUC of the three was 0.818 (95%CI:0.752-0.884),with sensitivity and specificity of 67.90% and 84.00%,respectively.According to the third quartile method,GRACE score,GPS,and CAR were divided into three groups (Q1-Q3).The incidence of MACE in the Q1,Q2,and Q3 groups was statistically significant (all P<0.05).After adjusting for confounding factors,the results showed that the risk of MACE in both Q2 and Q3 groups was higher than that in Q1 group (all P<0.001).Conclusion:GPS and CAR are both independent risk factors for NSTEMI in-hospital MACE,and their predictive efficacy can be improved when combined with GEACE score.

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备注/Memo

备注/Memo:
国家自然科学基金资助项目（82300380）
更新日期/Last Update: 2025-10-09