血小板体积分布宽度与老年人急性冠状动脉综合征病变程度的相关性
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摘要
目的探讨血小板体积分布宽度(PDW)与60岁以上急性冠状动脉综合征(ACS)患者冠状动脉病变程度的关系。方法回顾性分析心内科诊断为ACS的60岁及以上老年患者330例[年龄(66±6)岁]和行冠状动脉造影无冠状动脉病变的对照人群110例[年龄(66±6)岁]。经冠状动脉造影检查分为对照组(冠状动脉造影正常组) 110例,A组(冠状动脉单支病变组) 126例、B组(双支病变组) 116例和C组(多支病变组) 88例。比较分析4组的血小板参数及血脂水平等实验室指标并将其与冠状动脉病变程度进行相关性分析;采用受试者工作特征曲线分析PDW对ACS的界定值。结果与对照组比较,A组、B组和C组PDW增高(P <0. 001),血小板计数(PC)下降(P <0. 001),PC与PDW比值降低(P <0. 001),高密度脂蛋白胆固醇(HDL-C)降低(P <0. 001),差异有统计学意义。PDW与冠状动脉病变程度呈正相关(r=0. 618,P <0. 001)。受试者工作曲线分析结果显示,当以PDW的检测截点> 14. 9%作为ACS的诊断点,PDW诊断ACS的敏感度和特异度分别为92. 7%和95. 5%(曲线下面积AUC=0. 979,95%CI:0. 967~0. 990,P <0. 01)。结论PDW与老年患者ACS冠状动脉病变程度具有相关性,对ACS的早期诊断具有较好的临床价值。
Objective To investigate the correlation between platelet volume distribution width( PDW) and coronary artery lesion in elderly patients with acute coronary syndrome( ACS). Methods A retrospective analysis was conducted on 330 patients with ACS and 110 health subjects( control group),who were admitted to cardiology department of Heping Hospital Affiliated to Changzhi Medical College from April 2016 to July 2017. All subjects were divided into 4 groups,control group( n = 110),single branch coronary lesion group( Group A group,n = 126),double branches coronary lesion group( Group B,n = 116) and multiple branches coronary lesion group( Group C,n = 88). Baseline data were compared among the four groups,and the correlation between PDW and the degrees of coronary lesion was analyzed.Furthermore,receiver operating characteristic curve( ROC) analysis was performed to determine the value of PDW for diagnosing ACS. Results Baseline PDWs were significantly higher in Group A,B and C compared with control group( F = 254. 806,P < 0. 001). There was a significantly positive correlation between PDW and coronary lesion( r = 0. 618,P < 0. 001). When the PDW > 14. 9% was conducted as threshold,the sensitivity and specificity of PDW diagnosing ACS were 92. 7% and 95. 5%,respectively( AUCROC= 0. 979,95% CI; 0. 967-0. 990,P < 0. 01). Conclusions There is a good correlation between PDW and coronary artery lesion in elderly ACS patients.
Objective To investigate the correlation between platelet volume distribution width( PDW) and coronary artery lesion in elderly patients with acute coronary syndrome( ACS). Methods A retrospective analysis was conducted on 330 patients with ACS and 110 health subjects( control group),who were admitted to cardiology department of Heping Hospital Affiliated to Changzhi Medical College from April 2016 to July 2017. All subjects were divided into 4 groups,control group( n = 110),single branch coronary lesion group( Group A group,n = 126),double branches coronary lesion group( Group B,n = 116) and multiple branches coronary lesion group( Group C,n = 88). Baseline data were compared among the four groups,and the correlation between PDW and the degrees of coronary lesion was analyzed.Furthermore,receiver operating characteristic curve( ROC) analysis was performed to determine the value of PDW for diagnosing ACS. Results Baseline PDWs were significantly higher in Group A,B and C compared with control group( F = 254. 806,P < 0. 001). There was a significantly positive correlation between PDW and coronary lesion( r = 0. 618,P < 0. 001). When the PDW > 14. 9% was conducted as threshold,the sensitivity and specificity of PDW diagnosing ACS were 92. 7% and 95. 5%,respectively( AUCROC= 0. 979,95% CI; 0. 967-0. 990,P < 0. 01). Conclusions There is a good correlation between PDW and coronary artery lesion in elderly ACS patients.
引文
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[11]Su2ilovi GZ,Bakovi D,Lozo M,et al.Early Changes in Platelet Size and Number in Patients with Acute Coronary Syndrome[J].Int J Angiol,2017,26(4):249-252.
[12]Celik T,Kaya M,Akpek M,et al.Predictive value of admission platelet volume indices for in-hospital major adverse cardiovascular events in acute ST-segment elevation myocardial infarction[J].Angiology,2015,66(2):155-162.
[13]Vagdatli E,Gounari E,Lazaridou El,et al.Platelet distributionwidth:a simple,practical and specific marker of activation of coagulation[J].Hippokratia,2010,14(1):28-32.
[14]Cetin M,Bakirci EM,Baysal E,et al.Increased platelet distribution width is associated with ST-segment elevation myocardial infarction and thrombolysis failure[J].Angiology,2014,65(8):737-743.
[15]Bekler A,Ozkan MT,Tenekecioglu E,et al.Increased Platelet Distribution Width Is Associated With Severity of Coronary Artery Disease in Patients With Acute Coronary Syndrome[J].Angiology,2015,66(7):638-643.
[2]Ranjith MP,Divya R,Mehta VK,et al.Significance of platelet volume indices and platelet count in ischaemic heart disease[J].JClin Pathol,2009,62(9):830-833.
[3]Kowara M,Grodecki K,Huczek Z,et al.Platelet distribution width predicts left ventricular dysfunction in patients with acute coronary syndromes treated with percutaneous coronary intervention[J].Kardiol Pol,2017,75(1):42-47.
[4]Dehghani MR,Taghipour-Sani L,Rezaei Y,et al.Diagnostic importance of admission platelet volume indices in patients with acute chest pain suggesting acute coronary syndrome[J].Indian Heart J,2014,66(6):622-628.
[5]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志,2010,38(8):675-690.
[6]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.非ST段抬高急性冠状动脉综合征诊断和治疗指南[J].中华心血管病杂志,2012,40(5):353-367.
[7]Slavka GT,Perkmann T,Haslacher H,et al.Mean platelet volume may represent a predictive the parameter for overall vascular mortality and ischemic heart diseases[J].Arterioscler Thromb Vasc,2011,31(5):1215-1218.
[8]Chu H,Chen WI,Huang CC,et al.Diagnostic performance of mean platelet volume for patients with acute coronary syndrome visiting an emergency department with acute chest pain:the Chinese scenario[J].Emerg Mod J,2011,28(7):569-574.
[9]周晓霞,田昕.血小板平均体积与老年人急性ST段抬高型心肌梗死近期主要心血管事件的相关性研究[J].中华老年医学杂志,2016,35(1):75-78.
[10]Timóteo AT,Papoila AL,Lousinha A,et al.Predictive impact on medium-term mortality of hematological parameters in Acute Coronary Syndromes:added value on top of GRACE risk score[J].Eur Heart J Acute Cardiovasc Care,2015,4(2):172-179.
[11]Su2ilovi GZ,Bakovi D,Lozo M,et al.Early Changes in Platelet Size and Number in Patients with Acute Coronary Syndrome[J].Int J Angiol,2017,26(4):249-252.
[12]Celik T,Kaya M,Akpek M,et al.Predictive value of admission platelet volume indices for in-hospital major adverse cardiovascular events in acute ST-segment elevation myocardial infarction[J].Angiology,2015,66(2):155-162.
[13]Vagdatli E,Gounari E,Lazaridou El,et al.Platelet distributionwidth:a simple,practical and specific marker of activation of coagulation[J].Hippokratia,2010,14(1):28-32.
[14]Cetin M,Bakirci EM,Baysal E,et al.Increased platelet distribution width is associated with ST-segment elevation myocardial infarction and thrombolysis failure[J].Angiology,2014,65(8):737-743.
[15]Bekler A,Ozkan MT,Tenekecioglu E,et al.Increased Platelet Distribution Width Is Associated With Severity of Coronary Artery Disease in Patients With Acute Coronary Syndrome[J].Angiology,2015,66(7):638-643.