| 韩利娜.血清TBIL、WBC及FT3对急性心肌梗死术后全因死亡的预测价值[J].实用中西医结合临床,2023,23(7): |
| 血清TBIL、WBC及FT3对急性心肌梗死术后全因死亡的预测价值 |
| Value of Serum TBIL, WBC and FT3 in Predicting the Prognosis of Acute Myocardial Infarction |
| 投稿时间：2023-02-06 修订日期：2023-02-28 |
| DOI： |
| 中文关键词: 总胆红素 白细胞 游离T3 急性心肌梗死 术后全因死亡 预测价值 |
| 英文关键词: Total bilirubin White blood cells Free T3 Acute myocardial infarction Prognosis Predictive value |
| 基金项目: |
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| 中文摘要: |
| [摘要] 目的：探究血清总胆红素(TBIL)、白细胞（WBC）及游离T3(FT3)对急性心肌梗死（AMI）术后全因死亡的预测价值。方法：选择2018年1月-2020年6月我院收治的88例AMI患者，根据患者术后30天内存活情况分为生存组（n=65）与病死组（n=23），同期在我院体检健康者50例为对照组，比较三组血清TBIL、WBC及FT3水平，用spearman相关分析血清TBIL、WBC及FT3水平与AMI患者术后30天病死的相关性，Cox回归模型单因素和多因素分析AMI患者术后全因死亡影响因素，绘制血清TBIL、WBC及FT3水平不同的患者的Kaplan-Meier生存曲线，受试者工作特征曲线（ROC）分析血清TBIL、WBC及FT3水平预测AMI患者术后30天病死的价值。结果：生存组和病死组血清TBIL、FT3水平较对照组低（P<0.05），WBC水平较对照组高（P<0.05）；病死组血清TBIL、FT3水平较生存组低（P<0.05），WBC水平较生存组高（P<0.05）。相关性分析显示，血清TBIL及FT3水平与AMI患者术后30天病死呈负相关（P＜0.05），WBC水平与AMI患者术后30天病死呈正相关（P＜0.05）。COX回归模型显示，血清TBIL及FT3水平下降、WBC水平升高是AMI患者术后30天病死的危险因素（P＜0.05）。ROC分析显示，当TBIL＜13.91μmol/L、FT3＜11.43pmol/L、WBC＞12.30(×109/L)时，预测AMI患者术后30天病死的AUC为0.945，敏感性为91.30%，特异性为96.90%。Kaplan-Meier分析显示，TBIL＜13.91μmol/L组、FT3＜11.43pmol/L组、WBC＞12.30(×109/L)组术后30天病死率显著高于TBIL≥13.91μmol/L组、TBIL≥11.43pmol/L组、WBC≤12.30(×109/L)组（P＜0.05）。结论：血清TBIL、WBC及FT3是急性心肌梗死术后全因死亡的有效预测指标。 |
| 英文摘要: |
| [Abstract] Objective To investigate the prognostic value of serum total bilirubin (TBIL), white blood cell (WBC) and free T3 (FT3) for patients with acute myocardial infarction (AMI). Methods A total of 88 AMI patients in our hospital from January 2018 to June 2020 were enrolled, and divided into two groups according to 30d survival status, survival group (n=65) and death group (n=23), meanwhile, another 50 heathy individuals were set as control group. Serum TBIL, WBC and FT3 levels were compared among three groups. Spearman correlation was used to analyze the correlation between serum TBIL, WBC and FT3 levels and 30d mortality rate of AMI patients. Cox regression model was used to analyze factors influencing prognosis of AMI patients. Kaplan Meier survival curve was drawn for patients with different serum TBIL, WBC and FT3 levels. Receiver operating characteristic curve (ROC) was used to analyze the value of serum TBIL, WBC and FT3 levels in predicting 30d mortality in AMI patients. Results Serum TBIL and FT3 levels among three groups were the lowest in death group, followed by survival group, and were the highest in control group, with statistic difference (P<0.05). WBC among three groups was the highest in death group, followed by survival group, and was the lowest in control group, with statistic difference (P<0.05). Correlation analysis showed that 30d mortality rate of AMI patients was negatively correlated with serum TBIL and FT3 levels (P<0.05), was positively correlated with WBC (P<0.05). Cox regression model showed that the decrease of serum TBIL and FT3 levels and the increase of WBC levels were the risk factors of 30d mortality rate of AMI patients (P<0.05). ROC curve showed that the AUC, sensitivity and specificity of TBIL<13.91μmol/L, FT3<11.43pmol/L and WBC>12.30 (×109/L) in predicting the death of AMI patients were 0.945, 91.30% and 96.90% respectively. Kaplan-Meier analysis showed that the 30d mortality rate after TBIL<13.91μmol/L group, FT3<11.43pmol/L group and WBC>12.30(×109/L) group was significantly higher than that of TBIL≥13.91μmol/L group, TBIL ≥11.43pmol/L group and WBC≤12.30(×109/L) group, with statistic difference (P<0.05). Conclusion Serum TBIL, WBC and FT3 are effective predictors of the prognosis of patients with acute myocardial infarction. |
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