TyG指数、TyG-BMI指数对急性心肌梗死行急诊介入治疗患者主要不良心血管事件的预测价值

doi:10.3969/j.issn.1004-583X.2026.01.002

摘要/Abstract

摘要：

目的分析甘油三酯-葡萄糖(TyG)指数、甘油三酯-葡萄糖-体质(TyG-BMI)指数对急性心肌梗死(acute myocardial infarction,AMI)行急诊介入治疗患者预后的预测价值。方法回顾丹阳市人民医院2021年1月1日-2022年12月31日AMI行急诊介入治疗的患者201例,均在12 h内急诊介入开通罪犯血管,根据心电图表现分为急性非ST段抬高型心肌梗死(NSTEMI)组(n=40)、急性ST段抬高型心肌梗死(STEMI)组(n=161),根据TyG指数的中位数分为低分组(Q1组, n=100)、高分组(Q2组, n=101),取同期冠状动脉造影结果为阴性的患者96例为对照组,收集TyG、TyG-BMI指数等临床资料,随访24个月,记录主要不良心血管事件(major adverse cardiovascular events,MACE),分析TyG、TyG-BMI指数对AMI急诊介入治疗患者预后的预测价值。结果 ①与对照组相比,NSTEMI组TyG指数明显升高(9.16±0.72 vs 8.66±0.50, P<0.01);与对照组相比,STEMI组TyG指数明显升高(9.46±0.69 vs 8.66±0.63, P<0.01)。②与对照组相比,NSTEMI组TyG-BMI指数明显升高(241.04±39.49 vs 212.74±33.27, P<0.01);与对照组相比,STEMI组TyG-BMI指数明显升高(255.50±44.45 vs 212.74±33.27, P<0.01)。③STEMI组TyG指数、TyG-BMI指数均高于NSTEMI组(9.46±0.69 vs 9.16±0.72, 255.50±44.45 vs 241.04±39.49, P<0.05)。④TyG-BMI指数与肌钙蛋白I呈正相关(R=0.23, P<0.01), TyG-BMI指数与左心室舒张末期内径呈正相关(R=0.505, P<0.01), TyG-BMI指数与左心室射血分数呈负相关(R=-0.581, P<0.01),TyG-BMI指数与Gensini评分呈正相关(R=0.44, P<0.01)。⑤24个月MACE对比发现,NSTEMI组、STEMI组均高于对照组(P<0.05),Q2组高于Q1组(P<0.05)。⑥通过生存曲线Kaplan-Meier法分析得出TyG指数低的心肌梗死患者MACE发生相对较少。结论 TyG指数、TyG-BMI指数对AMI行急诊介入治疗患者MACE有预测价值。

关键词: 心肌梗死, 甘油三酯-葡萄糖指数, 甘油三酯-葡萄糖-体质指数, 主要不良心血管事件

Abstract:

Objective To evaluate the predictive value of the triglyceride-glucose index (TyG) and the TyG-body mass index (BMI) index for the prognosis of patients with acute myocardial infarction (AMI) treated with emergency percutaneous coronary intervention (PCI). Methods We retrospectively analyzed 201 consecutive AMI patients who underwent emergency PCI to open the culprit vessel within 12 hours at the People's Hospital of Danyang between January 1, 2021 and December 31, 2022. Patients were classified by electrocardiogram (ECG) into non ST elevation myocardial infarction (NSTEMI) group(n=40) and ST elevation myocardial infarction (STEMI) group (n=161). Based on the cohort median TyG value, patients were dichotomized into below-median (Q1) group (n=100) and above-median (Q2) TyG group (n=101). Ninety-six contemporaneous patients with negative coronary angiography served as controls. Clinical and laboratory data, including TyG and TyG-BMI indices, were collected. Patients were followed for 24 months for occurrence of major adverse cardiovascular events (MACE). The predictive value of TyG and TyG-BMI indices for the prognosis of patients with AMI treated with emergency PCI was analyzed. Results Both NSTEMI and STEMI patients had higher TyG and TyG-BMI indices than controls (TyG: NSTEMI 9.16±0.72 and STEMI 9.46±0.69 vs control 8.66±0.50, both P<0.01; TyG-BMI: NSTEMI 241.04±39.49 and STEMI 255.50±44.45 vs control 212.74±33.27, both P<0.01). STEMI patients exhibited higher TyG and TyG-BMI than NSTEMI patients (9.46±0.69 vs 9.16±0.72,255.50±44.45 vs 241.04±39.49, P<0.05). TyG-BMI correlated positively with cardiac troponin I (cTnI; R=0.23, P<0.01), left ventricular end-diastolic diameter (LVDd; R=0.505, P<0.01), and Gensini score (R=0.44, P<0.01), and negatively with left ventricular ejection fraction (LVEF; R=-0.581, P<0.01). At 24 months, MACE incidence was higher in the NSTEMI and STEMI groups than in controls (P<0.05), and higher in the TyG above-median (Q2) group than the below-median (Q1) group (P<0.05). Kaplan-Meier analysis showed fewer MACE events among patients with lower TyG values. Conclusion The TyG and TyG-BMI indices show prognostic value for patients undergoing emergency PCI.

Key words: myocardial infarction, triglyceride glucose (TyG) index, triglyceride glucose body mass index (TyG-BMI), major adverse cardiac events

中图分类号:

R542.22

欧阳巍立, 江宜乐. TyG指数、TyG-BMI指数对急性心肌梗死行急诊介入治疗患者主要不良心血管事件的预测价值[J]. 临床荟萃, 2026, 41(1): 12-17.

Ouyang Weili, Jiang Yile. TyG and TyG-BMI indices predict major adverse cardiovascular events after emergency revascularization for acute myocardial infarction[J]. Clinical Focus, 2026, 41(1): 12-17.

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参考文献 23

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项目	对照组(n=96)	NSTEMI组(n=40)	STEMI组(n=161)	χ²/F/Z值	P值
年龄(岁)	61.06±9.02	59.10±11.58	61.16±11.92	0.584	0.558
男[例(%)]	43(44.79)	36(90.00)^*	121(75.16)^*	36.000	<0.01
高血压[例(%)]	63(65.63)	31(77.50)	117(72.67)	2.390	0.303
糖尿病[例(%)]	15(15.63)	10(25.00)	53(32.92)^*	9.330	<0.01
BMI(kg/m²)	24.53±3.42	26.28±3.40^*	26.91±3.62^*	13.800	<0.01
FBG(mmol/L)	5.31±1.33	6.83±2.57^*	7.55±3.76^*	16.480	<0.01
TG(mmol/L)	1.52±0.63	2.16±1.28^*	2.66±1.57^*#	23.40	<0.01
TyG指数	8.66±0.50	9.16±0.72^*	9.46±0.69^*#	47.420	<0.01
TyG-BMI指数	212.74±33.27	241.04±39.49^*	255.50±44.45^*#	33.560	<0.01
TC(mmol/L)	4.49±1.08	4.81±1.08	4.93±1.02^*	5.250	<0.01
LDL(mmol/L)	2.49±0.74	2.92±0.81^*	3.04±0.79^*	15.410	<0.01
HDL(mmol/L)	1.19±0.28	1.08±0.31^*	1.11±0.24^*	3.630	0.028
Cr(μmol/L)	63.23±15.32	71.29±13.61^*	71.74±20.77^*	6.880	<0.01
UA(μmol/L)	313.31±75.11	338.29±83.41	340.25±101.26	2.760	0.065
LVEF(%)	68.06±3.94	64.08±6.05^*	60.65±9.17^*#	29.880	<0.01
LVDd(mm)	47.25±4.87	50.00±4.61^*	50.57±6.05^*	11.130	<0.01
cTnI(μg/L)	0.01(0.00, 0.10)	23.20(8.78, 36.29)^*	35.90(24.91, 56.43)^*#	202.620	<0.01
NT-proBNP(ng/L)	-	765.97(321.00, 1720.23)	1095.25(448.27, 2110.86)	2669.000	0.105
Gensini评分(分)	1.67±1.98	78.85±20.89^*	87.87±18.05^*#	948.690	<0.01
Killip分级(Ⅰ/Ⅱ/Ⅲ/Ⅳ)	-	36/4/0/0	125/27/3/6	18.260	<0.01
MACE(24个月)[例(%)]	1(1.04)	5(12.50)^*	21(13.04)^*	9.540	<0.01

项目	对照组(n=96)	NSTEMI组(n=40)	STEMI组(n=161)	χ²/F/Z值	P值
年龄(岁)	61.06±9.02	59.10±11.58	61.16±11.92	0.584	0.558
男[例(%)]	43(44.79)	36(90.00)^*	121(75.16)^*	36.000	<0.01
高血压[例(%)]	63(65.63)	31(77.50)	117(72.67)	2.390	0.303
糖尿病[例(%)]	15(15.63)	10(25.00)	53(32.92)^*	9.330	<0.01
BMI(kg/m²)	24.53±3.42	26.28±3.40^*	26.91±3.62^*	13.800	<0.01
FBG(mmol/L)	5.31±1.33	6.83±2.57^*	7.55±3.76^*	16.480	<0.01
TG(mmol/L)	1.52±0.63	2.16±1.28^*	2.66±1.57^*#	23.40	<0.01
TyG指数	8.66±0.50	9.16±0.72^*	9.46±0.69^*#	47.420	<0.01
TyG-BMI指数	212.74±33.27	241.04±39.49^*	255.50±44.45^*#	33.560	<0.01
TC(mmol/L)	4.49±1.08	4.81±1.08	4.93±1.02^*	5.250	<0.01
LDL(mmol/L)	2.49±0.74	2.92±0.81^*	3.04±0.79^*	15.410	<0.01
HDL(mmol/L)	1.19±0.28	1.08±0.31^*	1.11±0.24^*	3.630	0.028
Cr(μmol/L)	63.23±15.32	71.29±13.61^*	71.74±20.77^*	6.880	<0.01
UA(μmol/L)	313.31±75.11	338.29±83.41	340.25±101.26	2.760	0.065
LVEF(%)	68.06±3.94	64.08±6.05^*	60.65±9.17^*#	29.880	<0.01
LVDd(mm)	47.25±4.87	50.00±4.61^*	50.57±6.05^*	11.130	<0.01
cTnI(μg/L)	0.01(0.00, 0.10)	23.20(8.78, 36.29)^*	35.90(24.91, 56.43)^*#	202.620	<0.01
NT-proBNP(ng/L)	-	765.97(321.00, 1720.23)	1095.25(448.27, 2110.86)	2669.000	0.105
Gensini评分(分)	1.67±1.98	78.85±20.89^*	87.87±18.05^*#	948.690	<0.01
Killip分级(Ⅰ/Ⅱ/Ⅲ/Ⅳ)	-	36/4/0/0	125/27/3/6	18.260	<0.01
MACE(24个月)[例(%)]	1(1.04)	5(12.50)^*	21(13.04)^*	9.540	<0.01

项目	Q1组(n=101)	Q2组(n=100)	χ²/F/Z值	P值
年龄(岁)	62.58±11.80	58.89±11.68	4.980	0.027
男[例(%)]	81(80.20)	76(76.00)	0.520	0.472
高血压[例(%)]	71(70.30)	77(77.00)	1.160	0.281
糖尿病[例(%)]	18(17.82)	45(45.00)	17.250	<0.01
BMI(kg/m²)	25.94±3.22	27.64±3.73	12.020	<0.01
FBG(mmol/L)	6.20±1.83	8.63±4.39	26.340	<0.01
TG(mmol/L)	1.58±0.46	3.55±1.58	145.060	<0.01
TyG指数	8.88±0.35	9.93±0.56	255.020	<0.01
TyG-BMI指数	230.48±30.93	274.98±43.62	69.710	<0.01
TC(mmol/L)	4.75±1.00	5.06±1.04	4.790	0.030
LDL(mmol/L)	2.93±0.79	3.10±0.79	2.300	0.131
HDL(mmol/L)	1.10±0.25	1.10±0.26	0.100	0.920
Cr(μmol/L)	72.19±20.10	71.11±19.03	0.150	0.697
UA(μmol/L)	339.86±96.88	339.85±99.16	0.000	0.999
cTnI(μg/L)	24.91(20.28, 49.48)	42.30(24.91, 66.66)	3864.50	<0.01
NT-proBNP(ng/L)	1 089.92(400.25, 2 253.44)	972.23(375.75, 1 866.53)	4320.56	0.172
LVEF(%)	64.62±4.82	58.00±10.41	36.640	<0.01
LVDd(mm)	48.78±4.05	52.14±6.73	18.410	<0.01
Gensini评分(分)	80.22±18.30	91.99±17.77	21.380	<0.01
MACE[例(%)]	8(7.92)	18(18.00)	4.530	0.033

项目	Q1组(n=101)	Q2组(n=100)	χ²/F/Z值	P值
年龄(岁)	62.58±11.80	58.89±11.68	4.980	0.027
男[例(%)]	81(80.20)	76(76.00)	0.520	0.472
高血压[例(%)]	71(70.30)	77(77.00)	1.160	0.281
糖尿病[例(%)]	18(17.82)	45(45.00)	17.250	<0.01
BMI(kg/m²)	25.94±3.22	27.64±3.73	12.020	<0.01
FBG(mmol/L)	6.20±1.83	8.63±4.39	26.340	<0.01
TG(mmol/L)	1.58±0.46	3.55±1.58	145.060	<0.01
TyG指数	8.88±0.35	9.93±0.56	255.020	<0.01
TyG-BMI指数	230.48±30.93	274.98±43.62	69.710	<0.01
TC(mmol/L)	4.75±1.00	5.06±1.04	4.790	0.030
LDL(mmol/L)	2.93±0.79	3.10±0.79	2.300	0.131
HDL(mmol/L)	1.10±0.25	1.10±0.26	0.100	0.920
Cr(μmol/L)	72.19±20.10	71.11±19.03	0.150	0.697
UA(μmol/L)	339.86±96.88	339.85±99.16	0.000	0.999
cTnI(μg/L)	24.91(20.28, 49.48)	42.30(24.91, 66.66)	3864.50	<0.01
NT-proBNP(ng/L)	1 089.92(400.25, 2 253.44)	972.23(375.75, 1 866.53)	4320.56	0.172
LVEF(%)	64.62±4.82	58.00±10.41	36.640	<0.01
LVDd(mm)	48.78±4.05	52.14±6.73	18.410	<0.01
Gensini评分(分)	80.22±18.30	91.99±17.77	21.380	<0.01
MACE[例(%)]	8(7.92)	18(18.00)	4.530	0.033