APRI与老年射血分数保留心力衰竭病人右心功能和预后的相关性

doi:10.3969/j.issn.1003-9198.2023.04.015

摘要/Abstract

摘要： 目的探讨天冬氨酸转氨酶/血小板比率指数(APRI)与老年射血分数保留心力衰竭(HFpEF)病人右心功能和主要不良心血管事件(MACE)的相关性。方法回顾性选择2018年1月至2020年6月我院收治的115例老年HFpEF病人,所有病人出院均随访12个月,根据随访期间是否发生MACE分为MACE组(36例)和对照组(79例)。收集病人的临床资料,分析APRI与老年HFpEF病人右心功能指标[三尖瓣环收缩期位移(TAPSE)、三尖瓣环收缩期峰值速度(S′)]的相关性、老年HFpEF病人出院12个月后发生MACE的危险因素以及APRI预测老年HFpEF病人出院12个月后发生MACE的价值。结果 MACE组APRI、总胆红素(TBiL)、氨基末端-脑钠肽前体(NT-proBNP)水平,心房颤动(房颤)比例、NYHA分级Ⅳ级比例高于对照组(P＜0.05),白蛋白(ALB)、TAPSE、S′、LVEF水平低于对照组(P＜0.05)。老年HFpEF病人APRI与TAPSE、S′、LVEF均呈负相关(r=-0.513、-0.438、-0.596,P＜0.05)。房颤、APRI、NT-proBNP是老年HFpEF病人出院12个月后发生MACE的独立影响因素(P＜0.05)。APRI预测老年HFpEF病人出院12个月后发生MACE的AUC为0.779,与NT-proBNP比较,差异无统计学意义(Z=0.653,P＞0.05)。结论 APRI增高与老年HFpEF病人右心功能受损以及发生MACE有关,是评估老年HFpEF病人预后的一项新型潜在指标。

关键词: 天冬氨酸转氨酶, 血小板, 左室射血分数, 心力衰竭, 预后

Abstract: Objective To investigate the association of aspartate aminotransferase-to-platelet ratio index (APRI) with right heart function and major adverse cardiovascular events (MACE) in the elderly patients with heart failure with preserved ejection fraction (HFpEF). Methods A total of 115 elderly patients with HFpEF admitted to our hospital from January 2018 to June 2020 were retrospectively enrolled. All the patients were followed up for 12 months. According to whether MACE occurred during the follow-up period, they were divided into MACE group (n=36) and control group (n=79). The clinical data were collected. The correlation of APRI with right heart function indicators [tricuspid annular plane systolic excursion (TAPSE), tricuspid annulus peak systolic velocity (S′)], risk factors for MACE and the predictive value of APRI for MACE in the elderly patients 12 months after discharge were analyzed. Results The levels of APRI, total bilirubin (TBiL) and N-terminal pro-brain natriuretic peptide (NT-proBNP), and the proportion of atrial fibrillation and NYHA grade Ⅳ in MACE group were higher, and the levels of albumin (ALB), TAPSE, S′ and LVEF were lower than those in the control group (P<0.05). APRI was negatively correlated with TAPSE, S′ and LVEF in the elderly patients with HFpEF (r=-0.513, -0.438, -0.596; P<0.05). Atrial fibrillation, APRI and NT-proBNP were the independent influencing factors of MACE in the elderly patients with HFpEF 12 months after discharge (P<0.05). The area under the curve of APRI to predict MACE in the elderly patients with HFpEF 12 months after discharge was 0.779, and showed no significant difference from NT-proBNP (Z=0.653, P>0.05). Conclusions Increased APRI is associated with impaired right heart function and MACE in the elderly patients with HFpEF, which is a new potential prognostic index for elderly patients with HFpEF.

Key words: aspartate aminotransferase, platelet, left ventricular ejection fraction, heart failure, prognosis

中图分类号:

R 541.6

王春燕, 宋亚玲, 任海霞. APRI与老年射血分数保留心力衰竭病人右心功能和预后的相关性[J]. 实用老年医学, 2023, 37(4): 382-385.

WANG Chun-yan, SONG Ya-ling, REN Hai-xia. Correlations of APRI with right ventricular function and prognosis in elderly patients with heart failure with preserved ejection fraction[J]. Practical Geriatrics, 2023, 37(4): 382-385.

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