急性心肌梗死患者白细胞计数与平均血小板体积比值意义探讨
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摘要
目的探讨白细胞计数与平均血小板体积比值(WMR)检测水平在预测急性心肌梗死(acute myocardialinfarction,AMI)患者主要不良心血管事件(major adverse cardiovascular events,MACE)的应用价值。方法选取2013年1月至2015年1月,泸县人民医院住院治疗的187例AMI患者,根据经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后2年MACE发生情况,随机分为MACE组(82例)和非MACE组(105例),比较两组经PCI治疗前后WMR指标变化情况,及其与发生MACE的相关性。结果 PCI术后,非MACE组患者WMR低于MACE组,差异有统计学意义(χ~2=2.653,P=0.017),MACE组△WMR低于非MACE组,差异有统计学意义(χ~2=3.052,P=0.008)。两组患者病变血管数(χ~2=1.171,P=0.328)和侵犯血管分布(χ~2=1.039,P=0.151)差异无统计学意义。△WMR与术后2年MACE发生率呈负相关(r=-0.779,P=0.007)。结论 WMR可作为AMI患者PCI治疗前后MACE早期预测的重要检测指标,有助于AMI患者MACE发生的早期发现和病情监测。
Objective To investigate the value of leukocyte count and mean platelet volume ratio(WMR) in predicting the major adverse events(MACE) in patients with acute myocardial infarction(AMI). Methods A retrospective analysis of 187 AMI patients hospitalized in our hospital from January 2013 to January 2015 was conducted.According to the clinical data of MACE 2 years after emergency coronary intervention therapy for(PCI),it was divided into MACE Group(82 cases) and non-MACE Group(105 cases), compared the changes of WMR indexes between two groups before and after PCI and the correlation of MACE. Results The WMR of non-MACE group after emergency PCI was significantly lower than that of MACE group(χ~2=2.653, P=0.017), WMR in MACE group was significantly lower than that in non-MACE group(χ~2=3.052, P=0.008).There was no difference in the number of diseased vessels(χ~2=1.171,P=0.328)and the distribution of invading vessels(χ~2=1.039,P=0.151)between the two groups.There was a negative correlation between WMR and the incidence of MACE 2 years after operation(r=-0.779, P=0.007). Conclusions WMR can be used as an important index for early prediction of MACE before and after PCI treatment in AMI patients, it is helpful for early detection and condition monitoring of MACE in AMI patients.
Objective To investigate the value of leukocyte count and mean platelet volume ratio(WMR) in predicting the major adverse events(MACE) in patients with acute myocardial infarction(AMI). Methods A retrospective analysis of 187 AMI patients hospitalized in our hospital from January 2013 to January 2015 was conducted.According to the clinical data of MACE 2 years after emergency coronary intervention therapy for(PCI),it was divided into MACE Group(82 cases) and non-MACE Group(105 cases), compared the changes of WMR indexes between two groups before and after PCI and the correlation of MACE. Results The WMR of non-MACE group after emergency PCI was significantly lower than that of MACE group(χ~2=2.653, P=0.017), WMR in MACE group was significantly lower than that in non-MACE group(χ~2=3.052, P=0.008).There was no difference in the number of diseased vessels(χ~2=1.171,P=0.328)and the distribution of invading vessels(χ~2=1.039,P=0.151)between the two groups.There was a negative correlation between WMR and the incidence of MACE 2 years after operation(r=-0.779, P=0.007). Conclusions WMR can be used as an important index for early prediction of MACE before and after PCI treatment in AMI patients, it is helpful for early detection and condition monitoring of MACE in AMI patients.
引文
[1] 邱峰,王玥,邢玉龙,等.外周血中性粒细胞百分比与冠心病及冠状动脉血管狭窄程度的相关性研究[J].中国临床研究,2015,28(12):1600-1602.
[2] 马芳义,刘彩霞,赵建全.MPV、PDW在急性心肌梗死患者中变化的临床分析[J].重庆医学,2017,46(28):3988-3989.
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[7] 柯丽,成蓓,戚本玲,等.中性粒细胞/淋巴细胞比值对于糖尿病合并急性心肌梗死患者近期预后的预测价值[J].中华内分泌代谢杂志,2017,33(6):479-484.
[8] Herter JM,Rossaint J,Zarbock A.Platelets in inflammation and immunity[J].J Thromb Haemost,2014,12(11):1764-1775.
[9] 梁琦,雷新军,李红兵,等.急性心肌梗死患者红细胞分布宽度与平均血小板体积的回归分析[J].南方医科大学学报,2017,37(8):1022-1027.
[10] 蒋主辉,许黎莉,谢艳,等.白细胞计数与平均血小板体积比值对于急性心肌梗死患者PCI术后主要不良事件的预测价值[J].检验医学与临床,2017,14(12):1765-1767.
[11] 黎鹏,何立,张光宇,等.NLR,MPV及hs-CRP与冠心病的临床类型及冠脉狭窄程度的关联[J].心脏杂志,2015,15(1):23-26.
[12] 蔡利强,许洛伊,魏丽丽,等.平均血小板体积与抑郁症的相关性[J].上海精神医学,2017,29(1):21-29.
[13] 刘马超,杭莺,刘云,等.白细胞计数、中性粒细胞与淋巴细胞比值对急性心肌梗死患者短期预后的影响分析[J].中国心血管杂志,2018,23(5):384-388.
[14] 雷娜,张彦平,薛丽,等.白细胞计数及其分类对急性心肌梗死的诊断价值[J].检验医学与临床,2018,15(4):478-481.
[15] 屠春平,蔡云祥,邢铭芬,等.NLP和PLR对胸痛的冠心病患者心肌肌钙蛋白I升高的预测价值[J].医学研究杂志,2015,44(6):145-147.
[16] 周领.术前平均血小板体积与急性ST段抬高型心肌梗死患者行经皮冠状动脉介入效果的关系及预后价值[J].中国老年学杂志,2017,37(2):359-360.
[17] 何宝强.急性心肌梗死患者平均血小板体积变化的意义[J].心血管病学进展,2018,39(2):235-238.
[18] 王文斌,菅宏伟,程国杰,等.血小板参数对急性心肌梗死患者急诊介入治疗后主要不良心脏事件的影响[J].中国医药导报,2018,15(17):48-51.
[2] 马芳义,刘彩霞,赵建全.MPV、PDW在急性心肌梗死患者中变化的临床分析[J].重庆医学,2017,46(28):3988-3989.
[3] Bozkurt S,Kose A,Erdogan S,et al.MPV and other inflammatory markers in diagnosing acute appendicitis[J].J Pal Med Assoc,2015,65(6):637-641.
[4] Makdisse M,Katz M,Correa AG,et al.Effect of implementing an acute myocardial infarction guideline on quality indicators[J].J Food Sci,2013,7(5):388-393.
[5] Anvari MS,Boroumand MA,Karimi A,et al.Aortic and mitral valve atherosclerosis:predictive factors and associations with coronary atherosclerosis using gensini score[J].Arch Med Res,2009,40(2):124-127.
[6] 许云梦,徐晓东,方中,等.白细胞计数/平均血小板体积比值及中性粒细胞/淋巴细胞比值评估急性冠脉综合征患者介入治疗预后的价值[J].安徽医学,2017,38(1):33-37.
[7] 柯丽,成蓓,戚本玲,等.中性粒细胞/淋巴细胞比值对于糖尿病合并急性心肌梗死患者近期预后的预测价值[J].中华内分泌代谢杂志,2017,33(6):479-484.
[8] Herter JM,Rossaint J,Zarbock A.Platelets in inflammation and immunity[J].J Thromb Haemost,2014,12(11):1764-1775.
[9] 梁琦,雷新军,李红兵,等.急性心肌梗死患者红细胞分布宽度与平均血小板体积的回归分析[J].南方医科大学学报,2017,37(8):1022-1027.
[10] 蒋主辉,许黎莉,谢艳,等.白细胞计数与平均血小板体积比值对于急性心肌梗死患者PCI术后主要不良事件的预测价值[J].检验医学与临床,2017,14(12):1765-1767.
[11] 黎鹏,何立,张光宇,等.NLR,MPV及hs-CRP与冠心病的临床类型及冠脉狭窄程度的关联[J].心脏杂志,2015,15(1):23-26.
[12] 蔡利强,许洛伊,魏丽丽,等.平均血小板体积与抑郁症的相关性[J].上海精神医学,2017,29(1):21-29.
[13] 刘马超,杭莺,刘云,等.白细胞计数、中性粒细胞与淋巴细胞比值对急性心肌梗死患者短期预后的影响分析[J].中国心血管杂志,2018,23(5):384-388.
[14] 雷娜,张彦平,薛丽,等.白细胞计数及其分类对急性心肌梗死的诊断价值[J].检验医学与临床,2018,15(4):478-481.
[15] 屠春平,蔡云祥,邢铭芬,等.NLP和PLR对胸痛的冠心病患者心肌肌钙蛋白I升高的预测价值[J].医学研究杂志,2015,44(6):145-147.
[16] 周领.术前平均血小板体积与急性ST段抬高型心肌梗死患者行经皮冠状动脉介入效果的关系及预后价值[J].中国老年学杂志,2017,37(2):359-360.
[17] 何宝强.急性心肌梗死患者平均血小板体积变化的意义[J].心血管病学进展,2018,39(2):235-238.
[18] 王文斌,菅宏伟,程国杰,等.血小板参数对急性心肌梗死患者急诊介入治疗后主要不良心脏事件的影响[J].中国医药导报,2018,15(17):48-51.