葛正阳,何怡,蒋廷波,贺永明

• 1:苏州大学附属第一医院心血管内科

摘要(Abstract)：

目的 探讨血清白蛋白联合冠状动脉树描述及病变评估（CatLet~?）冠状动脉评分（简称复合模型）预测急性心肌梗死患者预后的价值。方法 连续纳入2012年1月至2013年7月因急性心肌梗死在苏州大学附属第一医院行急诊经皮冠状动脉介入治疗（PCI）的患者。计算非闭塞状态下CatLet~?冠状动脉评分，并收集入院时血清白蛋白水平等基线资料。主要终点为主要不良心脑血管事件（MACCE），次要终点为全因死亡和心原性死亡。通过受试者工作特征曲线下面积（AUC）、净再分类指数（NRI）与整体鉴别指数（IDI）比较CatLet~?冠状动脉评分单纯模型（简称单纯模型）及复合模型的区分能力。通过Hosmer-Lemeshow拟合优度检验与一致性曲线图，检测模型的校正度。结果 与单纯模型相比，复合模型MACCE、全因死亡以及心原性死亡AUC(95%CI)分别为[0.77(0.71～0.84)比0.71(0.64～0.78),P=0.010]、[0.80(0.73～0.86)比0.72(0.64～0.79),P=0.012]以及[0.82(0.75～0.88)比0.77(0.70～0.84),P=0.096]。进一步NRI和IDI分析表明，与单纯模型相比，复合模型中所有研究终点的NRI和IDI均大于0（均P <0.001），且复合模型较单纯模型有更好的校正度。结论 血清白蛋白联合CatLet~?冠状动脉评分复合模型可以更好地预测急性心肌梗死患者预后。

关键词(KeyWords)： 冠状动脉评分系统;血清白蛋白;急性心肌梗死;预后

Abstract:

Keywords:

基金项目(Foundation): 江苏省卫生健康委科研项目（M2021019）

作者(Author): 葛正阳,何怡,蒋廷波,贺永明

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