2026 年第 8 期 第 21 卷

三种复合标志物对急性冠状动脉综合征患者院内主要不良心血管事件的影响研究

Study on the effects of three composite biomarkers on in-hospital major adverse cardiovascular events in patients with acute coronary syndrome

作者：闫小丽1赵建全2

英文作者：Yan Xiaoli1 Zhao Jianquan2

单位：1内蒙古医科大学巴彦淖尔临床医学院，巴彦淖尔015000；2内蒙古自治区巴彦淖尔市医院心内科，巴彦淖尔015000

英文单位：1Bayannur Clinical Medical College of Inner Mongolia Medical University Bayannur 015000 China; 2Department of Cardiology Bayannur Hospital Inner Mongolia Autonomous Region Bayannur 015000 China

关键词：急性冠状动脉综合征；冠状动脉病变程度；主要不良心血管事件；单核细胞与高密度脂蛋白胆固醇比值；葡萄糖与淋巴细胞比值；内皮活化与应激指数自然对数

英文关键词：Acutecoronarysyndrome;Severityofcoronaryarterylesion;Majoradversecardiovascularevents;Monocytetohigh-densitylipoproteincholesterolratio;Glucosetolymphocyteratio;Naturallogarithmofendothelialactivationandstressindex

• 摘要：

• 目的 探究内皮活化与应激指数自然对数［ln（EASIX）］、葡萄糖与淋巴细胞比值(GLR)及单核细胞与高密度脂蛋白胆固醇比值(MHR)与急性冠状动脉综合征（ACS）患者院内主要不良心血管事件（MACE）及冠状动脉病变的关系。方法 回顾性分析2021年1月至2025年4月内蒙古自治区巴彦淖尔市医院急诊医学科及心内科收治的670例ACS患者病历资料。按照是否发生院内MACE将患者分为MACE组（74例）和非MACE组（596例），根据冠状动脉造影或冠状动脉CT结果分为单支和双支病变组、三支和/或左主干病变组。比较各组患者一般资料，分析ACS患者发生院内MACE的危险因素。分析各指标对ACS患者发生院内MACE和冠状动脉三支和/或左主干病变的预测价值。结果 调整混杂因素后，ACS患者ln（EASIX）水平升高增加MACE风险（比值比=4.226，95%置信区间：2.893～6.172，P＜0.001）。ln（EASIX）、GLR、MHR、急性肾损伤（AKI）和冠状动脉三支和/或左主干病变均是ACS患者院内MACE的独立危险因素（均P＜0.05）。ln（EASIX）预测ACS患者发生院内MACE的曲线下面积为0.816，ln（EASIX）、GLR、MHR、AKI及冠状动脉三支和/或左主干病变联合预测ACS患者发生院内MACE的曲线下面积为0.832。ln（EASIX）、GLR、MHR及三者联合预测ACS患者冠状动脉三支和/或左主干病变的曲线下面积分别为0.734、0.648、0.553、0.776。结论 ln（EASIX）是ACS患者发生院内MACE的独立危险因素，ln（EASIX）及多因素联合对ACS患者院内MACE有预测价值。ln（EASIX）、GLR、MHR及联合预测模型对ACS患者冠状动脉三支和/或左主干病变均有预测价值。

• Objective To explore the relationships of natural logarithm of endothelial activation and stress index ［ln(EASIX)］, glucose to lymphocyte ratio (GLR) and monocyte to high-density lipoprotein cholesterol ratio (MHR) with in-hospital major adverse cardiovascular events (MACE) and coronary artery lesions in patients with acute coronary syndrome (ACS). Methods The medical data of 670 ACS patients admitted to the Department of Emergency Medicine and Department of Cardiology, Bayannur Hospital, Inner Mongolia Autonomous Region from January 2021 to April 2025 were retrospectively analyzed. Patients were divided into MACE group (74 cases) and non-MACE group (596 cases) according to the occurrence of in-hospital MACE, and further divided into single and double-vessel lesion group and triple-vessel and/or left main lesion group based on coronary angiography or coronary computed tomography results. General clinical data were compared among groups, and the risk factors for in-hospital MACE in ACS patients were analyzed. The predictive values of the above indicators for in-hospital MACE and triple-vessel and/or left main coronary artery lesions in ACS patients were evaluated. Results After adjusting for confounding factors, elevated ln(EASIX) level increased the risk of MACE in ACS patients (odds ratio=4.226, 95% confidence interval: 2.893-6.172, P＜0.001). ln(EASIX), GLR, MHR, acute kidney injury (AKI) and triple-vessel and/or left main coronary artery lesion were all independent risk factors for in-hospital MACE in ACS patients (all P＜0.05). The area under the curve (AUC) of ln(EASIX) for predicting in-hospital MACE was 0.816, while the combined AUC of ln(EASIX), GLR, MHR, AKI and triple-vessel and/or left main coronary artery lesion was 0.832. The AUCs of ln(EASIX), GLR, MHR and their combination in predicting triple-vessel and/or left main coronary artery lesions were 0.734, 0.648, 0.553 and 0.776 respectively. Conclusions ln(EASIX) is an independent risk factor for in-hospital MACE in ACS patients. ln(EASIX) alone and combined multiple factors have good predictive value for in-hospital MACE. ln(EASIX), GLR, MHR and their combined prediction model all show predictive efficacy for triple-vessel and/or left main coronary artery lesions in ACS patients.