检验医学与临床2025，Vol.22Issue(9)：1199-1204,6.DOI:10.3969/j.issn.1672-9455.2025.09.009
NLR、GDF15联合心肌3项对急性胸痛危险分层的判断价值及对预后的预测价值
Judgment value of NLR,GDF15 combined with myocardial 3 items for risk stratification of acute chest pain and their predictive value for prognosis
摘要
Abstract
Objective To study the judgment value of neutrophil-to-lymphocyte ratio(NLR),growth dif-ferentiation factor-15(GDF15)combined with myocardial 3 items[cardiac troponin Ⅰ(cTnⅠ),myoglobin(Myo)and creatine kinase isoenzyme(CK-MB)]in the risk stratification of acute chest pain,and their predic-tive value for prognosis.Methods A total of 170 patients with acute chest pain admitted and treated in this hospital from January 2022 to August 2023 were selected as the acute chest pain group,and another 170 healthy subjects undergoing physical examination in this hospital during the same period were selected as the control group.NLR,GDF15 and myocardial 3 items were compared between the two groups.The patients with acute chest pain conducted the risk stratification by using the modified HEART score after admission and were divided into the high-risk,medium-risk and low-risk.NLR,GDF15 and myocardial 3 items were com-pared among the patients with acute chest pain in different risk stratifications,the relationship between each index and the risk stratification of acute chest pain was analyzed,and the receiver operating characteristic(ROC)curve was drawn to analyze the judgment value of NLR,GDF15 and myocardial 3 items in the risk stratification of acute chest pain.A 30 d follow-up was conducted after discharge.According to the follow-up results,the patients with acute chest pain were divided into the poor prognosis group and good prognosis group.The NLR,GDF15 and myocardial 3 items levels at admission were compared among the patients with different prognoses,and the predictive effect of each index on the prognosis of acute chest pain was analyzed.Results The GDF15,cTnⅠ,Myo and CK-MB levels and NLR in the acute chest pain group were higher than those in the control group(P＜0.05).The GDF15,cTnⅠ,Myo and CK-MB levels and NLR in high-risk pa-tients were higher than those in medium-risk and low-risk patients(P＜0.05),and the GDF15,cTnⅠ,Myo and CK-MB levels and NLR in medium-risk patients were higher than those in low-risk patients(P＜0.05).The Spearman correlation analysis showed that the GDF15,cTnⅠ,Myo and CK-MB levels and NLR were positively correlated with the risk stratification of acute chest pain(rs=0.685,0.762,0.727,0.751,0.649,all P＜0.001).The GDF15,cTnⅠ,Myo and CK-MB levels and NLR in the poor prognosis group were higher than those in the good prognosis group(P＜0.05).The results of ROC curve analysis showed that the area under the curve(AUC)of NLR,GDF15 and myocardial 3 items in the combined judgment for high-risk in the acute chest pain risk stratification was 0.935,which was greater than AUC(0.891)of the myocardial 3 items com-bined judgment for high-risk stratification of acute chest pain,and the difference was statistically significant(Z=1.994,P=0.046);AUC of NLR,GDF15 and myocardial 3 items in the combined prediction for the poor prognosis in the patients with acute chest pain was 0.938,which was greater than AUC(0.885)of the myo-cardial 3 items combined prediction for poor prognosis in the patients with acute chest pain,and the difference was statistically significant(Z=2.013,P=0.042).Conclusion NLR,GDF15 and myocardial 3 items are re-lated to the risk stratification of acute chest pain.The judgment value of NLR,GDF15 combined with myocar-dial 3 items for the risk stratification of acute chest pain is higher,moreover which has a higher predictive val-ue for the poor prognosis of the patients with acute chest pain.关键词
急性胸痛/分化生长因子-15/中性粒细胞与淋巴细胞比值/肌红蛋白/心肌肌钙蛋白Ⅰ/肌酸激酶同工酶Key words
acute chest pain/neutrophil to lymphocyte ratio/differentiation growth factor-15/myo-globin/cardiac troponin Ⅰ/creatine kinase isoenzyme分类
临床医学引用本文复制引用
祝勇军,邓小军..NLR、GDF15联合心肌3项对急性胸痛危险分层的判断价值及对预后的预测价值[J].检验医学与临床,2025,22(9):1199-1204,6.基金项目
2020年四川省医学(青年创新)科研课题项目(S20389). （青年创新）
