MPVLR对急性ST段抬高型心肌梗死患者直接PCI术后无复流的预测价值  

Predictive value of MPVLR for no-reflow after primary PCI in patients with acute ST-segment elevation myocardial infarction

作　　者：岳莉英[1] 李海文[1] 边云飞[1] YUE Liying;LI Haiwen;BIAN Yunfei(Department of Cardiology,the Second Hospital of Shanxi Medical University,Taiyuan,Shanxi 030001,China)

机构地区：[1]山西医科大学第二医院心内科,山西省太原市030001

出　　处：《中国动脉硬化杂志》2019年第1期40-44,共5页Chinese Journal of Arteriosclerosis

基　　金：国家自然科学基金项目(81170198)

摘　　要：目的探讨平均血小板体积/淋巴细胞比率(MPVLR)对急性ST段抬高型心肌梗死(STEMI)患者直接PCI术后有无复流的预测价值。方法选择2015年1月至2017年12月期间山西医科大学第二医院收治的因急性STEMI住院并于发病12 h内行直接PCI的患者304例。收集入选患者的基线资料及术前血常规参数计算得出血小板/淋巴细胞比率(PLR)、平均血小板体积/淋巴细胞比率(MPVLR)。按PCI术中冠状动脉有无复流分为正常血流组及无复流组,Logistic回归分析其危险因素。结果单因素分析显示,无复流组淋巴细胞计数明显低于正常血流组(P<0.05);无复流组平均血小板体积、PLR、MPVLR、高敏C反应蛋白、术中使用替罗非班、发病到球囊扩张时间、病变长度显著高于正常血流组(P<0.05)。多因素分析显示,PLR、MPVLR及发病到球囊扩张时间是预测急性STEMI患者直接PCI术后无复流的独立危险因素。PLR、MPVLR对应的ROC曲线下面积分别为0.766、0.795,预测的敏感性分别为73.8%、88.7%,特异性分别为69.1%、64.1%。结论 MPVLR能够有效预测急性STEMI患者直接PCI术后无复流的发生,其作为血常规常见指标的计算值,获取方便,值得推广。Aim To investigate the predictive value of mean platelet volume/lymphocyte ratio(MPVLR) in patients with acute ST-segment elevation myocardial infarction(STEMI) after primary percutaneous coronary intervention(p PCI).Methods From January 2015 to December 2017,a total of 304 patients who underwent p PCI,admitted within 12 hours from symptom onset,were enrolled and divided into two groups based on no-reflow.The platelet/lymphocyte ratio(PLR) and the MPVLR were calculated by collecting baseline data of patients enrolled and preoperative blood parameters.Logistic regression was used to analyze the risk factors.Results In univariate analysis,the lymphocyte count in the no-reflow group was significantly lower than that in the normal-reflow group(P<0.05);Mean platelet volume,PLR,MPVLR,high-sensitive C-reactive protein(hs-CRP),tirofiban in operation,pain-to-balloon time,and average stent length in the no-reflow group were significantly higher than those in the normal-reflow group(P<0.05).In multivariate analysis,PLR,MPVLR,and pain-to-balloon time were independent predictors of no-reflow after p PCI in patients with acute STEMI.The area under the ROC curves for PLR and MPVLR were 0.766 and 0.795,respectively.The sensitivity was73.8% and 88.7%,and the specificity was 69.1% and 64.1%,respectively.Conclusions MPVLR can effectively predict the occurrence of no-reflow after p PCI in patients with acute STEMI.As a calculated value of common indicators from blood routine examination,MPVLR is easy to get and deserved to be generalized.

关 键 词：平均血小板体积/淋巴细胞比率 急性ST段抬高型心肌梗死 直接PCI 无复流 

分 类 号：R542.22[医药卫生—心血管疾病]