2025 年第 7 期 第 20 卷

范超,张立新,戚楠,等.血尿素氮与白蛋白比值对急性心肌梗死合并室性心律失常患者短期全因死亡的预测价值

The predictive value of blood urea nitrogen to albumin ratio in short-term all-cause mortality in patients with acute myocardial infarction complicated with ventricular arrhythmias

作者：范超张立新戚楠彭红玉白硕范谦张喜维

英文作者：Fan Chao Zhang Lixin Qi Nan Peng Hongyu Bai Shuo Fan Qian Zhang Xiwei

单位：首都医科大学附属北京安贞医院健康门诊，北京100029

英文单位：Health Clinics Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：急性心肌梗死；室性心律失常；血尿素氮与白蛋白比值

英文关键词：Acutemyocardialinfarction;Ventriculararrhythmias;Bloodureanitrogentoalbuminratio

• 摘要：

• 目的 探究血尿素氮与白蛋白比值（BAR）在急性心肌梗死（AMI）合并室性心律失常（VA）患者预后评估中的作用。方法 回顾性选取2019年1月至2024年1月于首都医科大学附属北京安贞医院确诊为AMI合并VA患者954例，根据30 d内死亡情况分为生存组（696例）和死亡组（258例）。采用Logistic回归分析和亚组分析评估BAR与患者30 d内死亡的相关性。构建列线图模型，利用受试者工作特征曲线、Kolmogorov-Smirnov曲线、校准曲线和学习曲线进行模型评估。结果 死亡组BAR高于生存组［13.8（8.6,20.3）比7.3（4.9，11.9）］（P<0.001）。Logistic回归分析结果显示，BAR＞8.45是AMI合并VA患者30 d内死亡的独立危险因素（均P<0.05）。在训练集中，多因素Logistic回归分析结果显示，BAR＞8.45、年龄、收缩压、乳酸脱氢酶、呼吸频率、体温、急性肾损伤和脑卒中均为AMI合并VA患者30 d内死亡的独立影响因素（均P＜0.05）。基于上述影响因素构建列线图模型，在训练集、验证集和测试集中，该模型的曲线下面积分别为0.81、0.80和0.79。校准曲线和Kolmogorov-Smirnov曲线提示模型有较好的拟合度和区分度。结论 BAR是AMI合并VA患者30 d内全因死亡的独立危险因素。

• Objective  To investigate the prognostic value of blood urea nitrogen to albumin ratio (BAR) in patients with acute myocardial infarction (AMI) complicated with ventricular arrhythmias (VA). Methods A total of 954 patients diagnosed with AMI complicated with VA in Beijing Anzhen Hospital, Capital Medical University from January 2019 to January 2024 were retrospectively selected. They were divided into survival group (696 cases) and death group (258 cases) according to death within 30 d. Logistic regression analysis and subgroup analysis were used to evaluate the correlation between BAR and 30 d mortality of patients, and a nomogram model was constructed. The receiver operating characteristic curve, Kolmogorov-Smirnov curve, calibration curve and learning curve were used for model evaluation. Results The BAR in the death group was higher than that in the survival group ［13.8(8.6,20.3) vs 7.3(4.9,11.9)］(P<0.001). Logistic regression analysis showed that BAR>8.45 was an independent risk factor for death within 30 d in patients with AMI and VA (all P<0.05). In the training set, multivariate Logistic regression analysis showed that BAR>8.45, age, systolic blood pressure, lactate dehydrogenase, respiratory rate, body temperature, acute kidney injury and stroke were independent risk factors for death within 30 d in AMI patients with VA (all P<0.05). A nomogram model was constructed based on the above influencing factors. In the training set, validation set and test set, the area under the curve of the model was 0.81, 0.80 and 0.79, respectively. The calibration curve and Kolmogorov-Smirnov curve suggested that the model had good fit and discrimination. Conclusion BAR is an independent risk factor for all-cause death within 30 d in AMI patients with VA.