急性ST段抬高型心肌梗死患者平均血小板体积的变化及与冠状动脉影像的关系  

Mean platelet volume and its association with coronary angiograms in patients with acute ST-segment elevation myocardial infarction

作　　者：许文亮[1] 惠波[1] 武越[1] 张纯全[1] 夏伟[1] 邵一兵[1] 王旭[1] 

机构地区：[1]青岛市市立医院心内科,山东青岛266011

出　　处：《心脏杂志》2012年第5期613-616,共4页Chinese Heart Journal

摘　　要：目的:探讨急性ST段抬高型心肌梗死(STEMI)患者平均血小板体积(MPV)变化及与冠脉影像的关系。方法:STEMI患者200例,测定MPV和血生化等实验室指标,行心脏超声检查,阅读急诊冠脉造影结果,分析直接经皮冠脉介入术后梗死相关动脉的血流。选择同期接受冠脉造影但排除冠心病的住院患者200例作为对照。结果:STEMI患者MPV显著高于对照组;校正其它影响因素后,MPV与高密度脂蛋白胆固醇(HDL-C)和左室射血分数(LVEF)呈独立负相关,与冠脉病变积分呈独立正相关;MPV于冠脉多支病变亚组显著高于单支病变亚组,左前降支为梗死相关动脉亚组显著高于左回旋支亚组,梗死相关动脉无自发性开通亚组显著高于自发性开通亚组,直接经皮冠脉介入术后没有达到TIMIⅢ级血流的亚组显著高于达到TIMIⅢ级血流的亚组。结论:STEMI患者MPV显著升高,与冠脉病变严重程度和梗死相关动脉的慢血流有密切关系。AIM： To detect the changes of mean platelet volume （MPV） in patients with acute ST-segment elevation myocardial infarction （STEMI） and its association with coronary angiograms. METHODS： A total of 200 patients with STEMI who underwent emergency coronary angiography were enrolled. Admission MPV was measured and cardiac ultrasound examinations were conducted in the first 24 h. Gensini coronary score and infarct-related artery （IRA） flow before and after primary percutaneous coronary intervention （PPCI） were calculated. Two hundred in-hospital patients with non-CAD were used as controls. RESULTS： MPV significantly increased in STEMI patients compared with that in the control group. After adjustment, MPV was negatively correlated with HDL-C and left ventricular ejection （LVEF） but was positively correlated with Gisini coronary score. MPV in multiple lesions subgroup was significantly higher than in the single lesion subgroup and higher in the left anterior descending coronary artery as IRA subgroup than in the left circumflex artery as IRA subgroup. If angiographic IRA flow reached TIMI grade 1 -3 before PPCI, it was defined as spontaneous reperfusion. Patients without spontaneous reperfusion had markedly increased MPV compared with patients with spontaneous reperfusion. Patients whose IRA flow was less than TIMI grade 3 after PPCI had significantly elevated MPV compared with patients of TIMI grade 3. CONCLUSION： MPV is significantly increased in STEMI patients and MPV is associated with severity of coronary lesions and slow IRA flow.

关 键 词：心肌梗死 急性 平均血小板体积 冠状动脉病变积分 TIMI血流 

分 类 号：R541.4[医药卫生—心血管疾病]