QTcBaz联合NPAR及hs-CRP对急性心肌梗死患者PCI术后发生MACEs的预测价值

龙女; 罗春苗

doi:null

您当前的位置：

首页 >

文章列表页 >

QTcBaz联合NPAR及hs-CRP对急性心肌梗死患者PCI术后发生MACEs的预测价值

论著 | 更新时间：2026-04-28

- QTcBaz联合NPAR及hs-CRP对急性心肌梗死患者PCI术后发生MACEs的预测价值
- Predictive Value of QTcBaz Combined with NPAR and hs-CRP for Post-PCI MACEs in Patients with Acute Myocardial Infarction
- 临床心电学杂志 2026年35卷第2期页码：121-128
- 作者机构：
  
  1.230032 安徽合肥，安徽医科大学（龙女，罗春苗）
  2.230011 安徽合肥，合肥市第二人民医院，心血管内科（龙女，罗春苗）
- 作者简介：
  
  龙女，主要从事心血管内科疾病研究工作。
  罗春苗，E-mail： 15956072732@163.com
- 基金信息：
  
  合肥市卫生健康应用医学科研项目(Hwk2023zd009)
- DOI：
  中图分类号： R541.7　R540.4+1
- 收稿：2026-03-03，
  
  修回：2026-03-17，
  
  录用：2026-03-25，
  
  纸质出版：2026-04-28
- 稿件说明：
移动端阅览
龙女, 罗春苗. QTcBaz联合NPAR及hs-CRP对急性心肌梗死患者PCI术后发生MACEs的预测价值[J]. 临床心电学杂志, 2026, 35(2): 121-128.

LONG Nv,LUO Chunmiao..Predictive Value of QTcBaz Combined with NPAR and hs-CRP for Post-PCI MACEs in Patients with Acute Myocardial Infarction[J].J Clin Electrocardiol,2026,35(02):121-128.
龙女, 罗春苗. QTcBaz联合NPAR及hs-CRP对急性心肌梗死患者PCI术后发生MACEs的预测价值[J]. 临床心电学杂志, 2026, 35(2): 121-128. DOI：

LONG Nv,LUO Chunmiao..Predictive Value of QTcBaz Combined with NPAR and hs-CRP for Post-PCI MACEs in Patients with Acute Myocardial Infarction[J].J Clin Electrocardiol,2026,35(02):121-128. DOI：

摘要

目的

通过对比不同心率校正公式对AMI患者PCI术后预后的评估影响，筛选最优电生理指标，进而探讨QTcBaz联合中性粒细胞百分比与白蛋白比值（NPAR）及超敏C反应蛋白（hs-CRP）对MACEs的预测价值。

方法

回顾性分析288例行PCI治疗的AMI患者资料。根据术后是否发生MACEs分为事件组（

=72）与无事件组（

=216）。通过对比Bazett、Fridericia、Framingham及Hodges公式生成的QTc间期筛选最优电生理指标，采用多因素Logistic回归筛选独立危险因素并构建递进式预测模型。

结果

事件组多种QTc校正指标QTcBaz、QTcFri、QTcFra、QTcHo均显著高于无事件组（

0.05），ROC曲线显示QTcBaz的预测效能最优（AUC=0.734），显著优于其他校正公式；多因素回归显示，在校正年龄、心功能及冠脉病变程度后，QTcBaz［

=1.024 95%

（1.013~1.035）］、NPAR［

=3.518 95%

（1.205~10.271）］及ln（hs-CRP）［

=1.955 95%

（1.397~2.736）］是MACEs的独立危险因素（均

0.05）；模型效能：基础临床模型（模型A）的AUC为0.831；整合了电学脆弱性与炎症负荷维度的最终联合模型（模型D）效能最优，AUC达0.882，灵敏度86.5%，特异度80.4%，其预测价值显著优于传统临床模型（∆AUC=0.051，

=3.894，

0.001）。

结论

QTcBaz、NPAR及hs-CRP均是AMI患者术后MACEs的独立预后因素；在多种心率校正公式中，QTcBaz具有更佳的风险识别效能；在传统临床指标基础上联合心电学与炎症指标，可显著提升风险预测效能。

Abstract

Objective To investigate the predictive value of QTcBaz combined with neutrophil percentage/ albumin ratio

and high-sensitivity C-reactive protein for major adverse cardiovascular and cerebrovascular events (MACEs) following percutaneous coronary intervention (PCI) in patients with acute myocardial infarction

and to compare the impact of different heart rate correction formulas on prognostic assessment. Methods A retrospective analysis of 288 patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Patients were categorized into an event group (

=72) and a non-event group (

=216) based on the occurrence of MACEs p

ostoperatively. The optimal electrophysiological indicator was identified by comparing QTc intervals derived from the Bazett

Fridericia

Framingham

and Hodges formulas. Independent risk factors were selected using multivariate logistic regression

and a stepwise predictive model was constructed.

Results

①Multiple QTc correction indices in the event group (QTcBaz

QTcFri

QTcFra

and QTcHo) were significantly higher than those in the non-event group (

0.05). ROC curve analysis demonstrated that QTcBaz exhibited the highest predictive performance (AUC=0.734)

significantly outperforming other correction formulas; ②Multivariate regression analysis revealed that after adjusting for age

cardiac function

and coronary artery disease severity

QTcBaz[

=1.024 95%

(1.013~1.035)

]

、NPAR[

=3.518 95%

(1.205~10.271)

]

and (hs-CRP)[

=1.955 95%

(1.397~2.736)

]

were independent risk factors for MACEs (all

0.05); ③Model performance: The AUC of the baseline clinical model (Model A) was 0.831; The final combined model (Model D)

integrating electrical vulnerability and inflammatory burden dimensions

demonstrated optimal performance with an AUC of 0.882

sensitivity of 86.5%

and specificity of 80.4%. Its predictive value significantly surpassed that of traditional clinical models (∆AUC=0.051

=3.894

0.001).

Conclusions

QTcBaz

NPAR

and hs-CRP are all independent prognostic factors for postoperative MACEs in AMI patients. Among various heart rate correction formulas

QTcBaz demonstrates superior risk identification performance.Combining these with traditional clinical indicators

along with electrocardiographic and inflammatory markers

significantly enhances risk prediction performance.

关键词

Keywords

references

Tsao C W , Aday A W , Almarzooq Z I , et al . Heart disease and stroke statistics-2023 update: a report from the American heart association [J ] . Circulation , 2023 , 147 （ 8 ）: e93 - e621 .

龚艳君 , 霍勇 . 急性ST段抬高型心肌梗死诊断和治疗指南（2019）解读 [J ] . 中国心血管病研究 , 2019 , 17 ( 12 ): 1057 - 1061 .

杨继 , 张垚 , 马腾 , 等 . 1990—2019 年中国心血管疾病流行现状、疾病负担及发病预测分析 [J ] . 中国全科医学 , 2024 , 27 ( 2 ): 233 - 244 .

Stone G W , Kappetein A P , Sabik J F , et al . Five-year outcomes after PCI or CABG for left main coronary disease [J ] . N Engl J Med , 2019 , 381 ( 19 ): 1820 - 1830 .

Romeo F J , Golino M , Morello M , et al . Residual inflammatory risk and clinical outcomes after contemporary percutaneous coronary intervention： a systematic review and meta-analysis [J ] . Sci Rep , 2026 , 16 : 8584 .

Herwald H , Egesten A . C-reactive protein： more than a biomarker [J ] . J Innate Immun , 2021 , 13 ( 5 ): 257 - 258 .

张芹 , 程毅松 , 贾禹 , 等 . 中性粒细胞百分比与白蛋白比值对急性ST段抬高型心肌梗死患者预后的预测价值分析 [J ] . 临床急诊杂志 , 2020 , 21 ( 5 ): 354 - 358 .

Guaricci A I , Carità P , Lorenzoni V , et al . QT-interval evaluation in primary percutaneous coronary intervention of ST-segment elevation myocardial infarction for prediction of myocardial salvage index [J ] . PLoS One , 2018 , 13 ( 2 ): e0192220 .

牛学明 , 王付启 , 张芳 , 等 . 冠心病患者Gensini评分及左心功能参数的64排CT评价 [J ] . 中国CT和MRI杂志 , 2016 , 14 ( 4 ): 45 - 48 .

Thygesen K , Alpert J S , Jaffe A S , et al . Fourth universal definition of myocardial infarction （2018） [J ] . J Am Coll Cardiol , 2018 , 72 ( 18 ): 2231 - 2264 .

董磊 , 樊泽元 . 中性粒细胞百分比/白蛋白比值（NPAR）对冠状动脉支架内再狭窄的预测价值 [J ] . 吉林医学 , 2020 , 41 ( 11 ): 2565 - 2567 .

Bazett H C . An analysis of the time-relations of electrocardiograms [J ] . Ann Noninvasive Electrocardiol , 1997 , 2 ( 2 ): 177 - 194 .

Ridker P M . C-reactive protein and the prediction of cardiovascular events among those at intermediate risk： moving an inflammatory hypothesis toward consensus [J ] . J Am Coll Cardiol , 2007 , 49 ( 21 ): 2129 - 2138 .

张令生 . 急性心肌梗死患者QT间期离散度的临床价值 [J ] . 河北医药 , 2001 , 23 ( 2 ): 94 - 95 .

Vink A S , Neumann B , Lieve K V V , et al . Determination and interpretation of the QT interval [J ] . Circulation , 2018 , 138 ( 21 ): 2345 - 2358 .

吴月娥 , 胡泽平 , 马兰 , 等 . 梗死区Tp-ec及Tp-e/QT值对ST段抬高型心肌梗死患者的预后价值分析 [J ] . 安徽医科大学学报 , 2020 , 55 ( 5 ): 790 - 794 .

王鑫 , 孙振国 , 胡志成 , 等 . 急性冠脉综合征不同程度冠脉病变患者血浆高敏C反应蛋白检测及其意义 [J ] . 中国循证心血管医学杂志 , 2010 , 2 ( 3 ): 156 - 158 .

邵亚晓 , 李现立 , 贾研研 , 等 . 急性ST段抬高型心肌梗死患者经皮冠状动脉介入治疗术后合并恶性室性心律失常的影响因素 [J ] . 临床心电学杂志 , 2025 , 34 ( 5 ): 334 - 338 .

杨玉琴 , 吴祥树 . QRS时限联合系统免疫炎症指数预测急性心肌梗死患者PCI术后的预后 [J ] . 临床心电学杂志 , 2025 , 34 ( 6 ): 433 - 437 .

周仟慧 , 古满平 . 急性冠脉综合征不良心血管事件机器学习预测模型的研究进展 [J ] . 现代医药卫生 , 2024 , 40 ( 17 ): 3023 - 3027 .

钟杭美 . 动态心电图预警心脏性猝死 [J ] . 临床心电学杂志 , 2007 , 16 ( 5 ): 352 - 355 .

何谨 . QT间期动态性对急性心肌梗死患者心律失常事件的预测价值 [J ] . 实用预防医学 , 2011 , 18 ( 7 ): 1318 - 1320 .

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

急性心肌梗死患者高敏肌钙蛋白I对不良心血管事件的预测价值

尼可地尔对老年STEMI患者行PCI术的效果

急性心肌梗死PCI术后无复流现象的影响因素

ST段抬高的致命陷阱：主动脉夹层

胸前导联ST段抬高的伪装——一个“错解”的心电图向量警示与解析及临床启示