| 韩利娜，康敬敬，夏玲玲.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):96-100 |
| 血清TBil、WBC及FT3对急性心肌梗死术后全因死亡的预测价值 |
| Prognostic Value of Serum TBil, WBC and FT3 in All-Cause Death after Acute Myocardial Infarction |
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| DOI： |
| 中文关键词: 急性心肌梗死 总胆红素 白细胞 游离T3 术后全因死亡 预测价值 |
| 英文关键词: Acute myocardial infarction Total bilirubin White blood cells Free T3 Postoperatively all causes of death Predictive value |
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| 中文摘要: |
| 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：选取2018年1月至2020年6月医院收治的88例AMI患者，根据患者术后30 d内存活情况分为生存组（n=65）与病死组（n=23），另选取同期在医院体检的健康者50例为对照组。比较三组血清TBil、WBC及FT3水平，采用Spearman相关分析血清TBil、WBC及FT3水平与AMI患者术后30 d死亡的相关性，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 d死亡的价值。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 d死亡呈负相关（P＜0.05），WBC水平与AMI患者术后30 d死亡呈正相关（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 d死亡的危险因素（P＜0.05）；ROC分析显示，当TBil＜13.91 ?滋mol/L、FT3＜11.43 pmol/L、WBC＞12.30×109/L时，预测AMI患者术后30 d死亡的AUC为0.945，敏感性为91.30%，特异性为96.90%；Kaplan-Meier分析显示，患者TBil＜13.91 ?滋mol/L、FT3＜11.43 pmol/L或WBC＞12.30×109/L时，其术后30 d死亡率显著高于TBil≥13.91 ?滋mol/L、FT3≥11.43 pmol/L或WBC≤12.30×109/L时（P＜0.05）。结论：血清TBil、WBC及FT3是AMI术后全因死亡的有效预测指标。 |
| 英文摘要: |
| 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 30 d 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 30 d mortality rate of AMI patients after surgery. COX regression model was used to analyze univariate and multivariate factors of postoperative all-cause death in AMI patients. Kaplan Meier survival curve was drawn for patients with different serum TBil, WBC and FT3 levels. Receiver operating characteristic curve (ROC curve) was used to analyze the value of serum TBil, WBC and FT3 levels in predicting 30 d mortality in AMI patients.Results: The serum TBil and FT3 levels in survival and death groups were lower than those in control group (P＜0.05), and the serum WBC level was higher than that in control group (P＜0.05). The serum TBil and FT3 levels in the death group were lower than those in the survival group (P＜0.05), and the serum WBC level was higher than those in the survival group (P＜0.05). Correlation analysis showed that 30 d 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 30 d mortality rate of AMI patients (P＜0.05). ROC analysis showed that when TBil＜13.91 μmol/L, FT3＜11.43 pmol/L or WBC＞12.30×109/L, the AUC of predicting death 30 days after surgery in AMI patients was 0.945, the sensitivity was 91.30%, and the specificity was 96.90%. Kaplan-Meier analysis showed that when TBil＜13.91 μmol/L, FT3＜11.43 pmol/L or WBC＞12.30×109/L, the 30-day postoperative mortality was significantly higher than that of TBil≥13.91 μmol/L, TBil≥11.43 pmol/L or WBC≤12.30×109/L (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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