心脑血管病防治2026，Vol.26Issue(2)：11-15,5.DOI:10.3969/j.issn.1009-816x.2026.02.003
乳酸/白蛋白比值对重症非ST段抬高型心肌梗死患者预后的预测价值
Predictive value of lactate-to-albumin ratio on prognosis in critically ill patients with non-ST-segment elevation myocardial infarction
摘要
Abstract
Objective To investigate the predictive value of the lactate-to-albumin ratio(LAR)on the prognosis of critically ill patients with non-ST-segment elevation myocardial infarction(NSTEMI).Methods A retrospective analysis was conducted on 443 patients with NSTEMI from the Medical Information Mart for Intensive CareⅣ(MIMIC-Ⅳ,v2.0).Patients were divided into survival(317 cases)and non-survival(126 cases)groups based on 30-day outcomes,and their general characteristics were compared.Restricted cubic splines(RCS)were used to obtain the cutoff values of LAR grouping.LAR patients were divided into the low LAR group and the high LAR group.Kaplan-Meier survival curves were plotted to compare the cumulative survival rates at 30 and 90 days between the two groups.Cox proportional hazards regression models were used to analyze the association between LAR and 30-day mortality.Receiver operating characteristic(ROC)curves were used to assess the predictive value of LAR for 30-day mortality.Results LAR was significantly higher in the non-survival group(Z=-6.978,P<0.05).RCS analysis showed a nonlinear relationship between LAR and the risk of 30-day all-cause mortality in critically ill NSTEMI patients(χ2=28.650,P<0.01).When the HR for 30-day all-cause mortality was 1,the corresponding LAR value was 0.625.Accordingly,patients were stratified into a low LAR group(<0.625,224 cases)and a high LAR group(≥0.625,219 cases).Kaplan-Meier survival curves showed that the high LAR group had lower cumulative survival rates at both 30 and 90 days compared to the low LAR group(χ2=41.444,P<0.01;χ2=36.327,P<0.01).Multivariate Cox analysis revealed that high LAR was a risk factor for 30-day all-cause mortality in critically ill NSTEMI patients(P<0.05).ROC curve analysis yielded an area under the curve(AUC)of 0.712 for LAR in predicting 30-day mortality in critically ill NSTEMI patients,with a sensitivity of 0.667 and a specificity of 0.688.Conclusion Elevated LAR at ICU admission is a risk factor for 30-day all-cause mortality in critically ill NSTEMI patients and can be used to predict 30-day prognosis.关键词
乳酸/白蛋白比值/非ST段抬高型心肌梗死/预测价值Key words
Lactate-to-albumin ratio/Non-ST-segment elevation myocardial infarction/Predictive value引用本文复制引用
王红梅,顾秀明,范淑尧,廖骏,于翔..乳酸/白蛋白比值对重症非ST段抬高型心肌梗死患者预后的预测价值[J].心脑血管病防治,2026,26(2):11-15,5.基金项目
浙江省教育厅一般科研项目(Y202353809) （Y202353809）
