急性心肌梗死患者PCI术前血小板参数、NLR与院内MACE发生的关系
摘要
目的分析急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术前血小板参数[(血小板平均体积(MPV)、血小板分布宽度(PDW)]、中性粒细胞/淋巴细胞(NLR)与院内主要不良心血管事件(MACE)发生的关系。方法选择急诊行PCI的AMI患者480例,根据是否发生MACE分为发生者与未发生者,比较两者术前MPV、PDW、NLR,应用多因素Logistic回归分析分析AMI患者发生MACE的危险因素。绘制MPV、PDW、NLR预测MACE发生的受试者工作特征(ROC)曲线。结果 480例AMI患者中,56例发生院内MACE。MACE发生者较未发生者NLR、MPV、PDW高(P均<0.01)。Logistic回归分析结果显示,PCI术前高NLR(OR=20.431,95%CI:6.794～70.168,P<0.05)、高MPV(OR=1.593,95%CI:1.075～5.169,P<0.05)、高PDW(OR=2.049,95%CI:0.846～9.082,P<0.05)是AMI患者发生院内MACE的独立危险因素。ROC曲线分析结果显示,NLR、MPV、PDW预测院内MACE发生的ROC曲线下面积分别为0.848、0.782、0.709。结论 AMI患者PCI术前MPV、PDW、NLR与院内MACE发生有关,三者水平升高可在一定程度上预测院内MACE发生。
引文
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[11] iek G,Akgoz SK,Bozbay M,et al.Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio combination can predict prognosis in patients with ST-segment elevation myocardial infarctionundergoing primary percutaneous coronary intervention[J].Angiology,2015,66(5):441-447.
[12] Pan W,Zhao D,Zhang C,et al.Application of Neutrophil/lymphocyte ration in predicting coronary blood flow and mortality in patients with ST- elevation myocardial infarction undergoing percutaneous coronary intervention[J].J Cardiol,2015,66(1):9-14.
[13] 肖暖,唐路宁,谭莉莉,等.白细胞计数与急性心肌梗死预后的研究进展[J].医学研究与教育,2014,31(6):89-94.
[2] Park Y,Schoene N,Harris W.Mean platelet volume as an indicator of platelet activation:methodological issues[J].Platelet,2002,13(5-6):301-306.
[3] Kaya MG,Akpek M,Lam YY,et al.Prognostic value of neutrophil/lymphocyte ratio in patients with ST-elevated myocardial infarction undergoing primary coronary intervention:a prospective,multicenter study[J].Int J Cardiol,2013,168(2):1154-1159.
[4] 任洁,马宾,王明霞,等.血小板参数与冠心病患者冠状动脉病变程度相关性研究[J].中国循证心血管医学杂志,2014,4(6):714-716.
[5] 刘年安,李新,钱江,等.急性心肌梗死患者冠脉病变程度与外周血炎症介质的关系研究[J].贵州医药,2016,40(1):43-44.
[6] 孙薇,姬晓波,时伟彬,等.血栓抽吸在ST段抬高型急性心肌梗死PCI治疗中应用价值研究[J].现代仪器与医疗,2013,19(6):66-68.
[7] Yaman M,Arslan U,Beton O,et al.Early and late aortic propagation velocity values in STEMI patients after successful primary PCI and their relationship with neutrophil to lymphocyte ratio[J].Eur Rev Med Pharmacol Sci,2016,20(5):912-918.
[8] Akin F,Ayca B,Celik O,et al.Predictors of poor coronary collateral development in patients with stable coronary artery disease:Neutrophil-to-lymphocyte ratio and platelets[J].Anatol J Cardiol,2015,15(3):218-223.
[9] Cemin R,Donazzan L,Lippi G,et al.Blood cells characteristics as determinants of acute myocardial infarction[J].Clin Chem Lab Med,2011,49(7):1231-1236.
[10] Niu X,Yang C,Zhang Y,et al.Mean platelet volume on admission improves risk prediction in patients with acute coronary syndromes[J].Angiology,2015,66(5):456-463.
[11] iek G,Akgoz SK,Bozbay M,et al.Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio combination can predict prognosis in patients with ST-segment elevation myocardial infarctionundergoing primary percutaneous coronary intervention[J].Angiology,2015,66(5):441-447.
[12] Pan W,Zhao D,Zhang C,et al.Application of Neutrophil/lymphocyte ration in predicting coronary blood flow and mortality in patients with ST- elevation myocardial infarction undergoing percutaneous coronary intervention[J].J Cardiol,2015,66(1):9-14.
[13] 肖暖,唐路宁,谭莉莉,等.白细胞计数与急性心肌梗死预后的研究进展[J].医学研究与教育,2014,31(6):89-94.