平均血小板体积和Gensini积分预测ST段抬高型心肌梗死患者急诊介入治疗后近期预后的价值  

Value of mean platelet volume and Gensini score on predicting short-term outcome in acute ST segment elevation myocardial infarction patient post emergency percutaneous coronary intervention

作　　者：秦文沛 杨毅宁[1] 李晓梅[1] 门莉[1] 郭俊林[1] 刘芬 孙惠萍[1] 徐锐[1] 李东泽[1] 

机构地区：[1]新疆医科大学第一附属医院心脏中心冠心病一科,乌鲁木齐830054 [2]新疆维吾尔自治区心血管病研究重点实验室

出　　处：《中华心血管病杂志》2015年第1期22-25,共4页Chinese Journal of Cardiology

基　　金：国家自然科学基金（81160042）;教育部新世纪优秀人才支持计划（NCET-11-1074）

摘　　要：目的 探讨平均血小板体积（MPV）和Gensini积分预测接受急诊经皮冠状动脉介入治疗（PCI）的急性ST段抬高型心肌梗死患者住院期间及术后6个月预后的价值.方法 连续入选2011年9月至2013年6月入院的接受急诊PCI的急性ST段抬高型心肌梗死患者102例.患者在入院即刻检查血常规,根据冠状动脉造影结果计算Gensini积分,并观察患者在住院期间及术后6个月发生的主要不良心血管事件（MACE）.结果 发生MACE患者的MPV、Gensini积分、冠状动脉三支病变比例均高于未发生MACE患者（P＜0.05或0.01）.MPV联合Gensini积分预测住院期间发生MACE的受试者工作特征曲线下面积（AUC）为0.836（95％ CI：0.706 -0.966,P=0.003）,预测术后6个月发生MACE的AUC为0.718 （95％ CI：0.571-0.866,P=0.006）.Kaplan-Meier生存分析显示,术后6个月高MPV（＞ 10.65 fl）患者无MACE发生率低于低MPV（≤10.65 fl）患者（log-rank =4.272,P=0.039）;Gensini积分高（＞89分）患者无MACE发生率低于积分低（≤89分）患者（log-rank=7.355,P=0.007）.结论 MPV联合Gensini积分对急性ST段抬高型心肌梗死患者住院期间和术后6个月发生MACE有较高的预测价值.Objective To explore the value of mean platelet volume （MPV） and Gensini score on predicting short-term prognosis of patients with acute ST segment elevation myocardial infarction （STEMI） post emergency percutaneous coronary intervention （PCI）.Methods From September 2011 to June 2013,102 consecutive hospitalized STEMI patients undergoing emergency PCI were included.All patients routine blood test was made immediately after admission,and Gensini score was calculated according to the results of coronary angiography.Incidence of major adverse cardiac events （MACE） during hospitalization and 6 months after PCI was observed.Results MPV,Gensini score and percent of coronary artery three vessel lesions were significantly higher in MACE patients than in patients without MACE（P 〈 0.05 or 0.01）.Area under the curve （AUC） of MPV plus Gensini score for predicting in hospital MACE and at 6 months post PCI was 0.836 （95% CI：0.706-0.966,P =0.003） and 0.718 （95% CI：0.571-0.866,P =0.006）,respectively.Kaplan-Meier survival analysis showed that incidence of without MACE at 6 months post PCI was significantly lower in patients with high MPV （〉 10.65 f1）than in patients with low MPV（≤ 10.65 f1） at admission （log-rank =4.272,P =0.039）,and in patients with high Gensini score （〉 89） than in low Gensini score（≤89） （log-rank =7.355,P =0.007） at admission.Conclusions High MPV and Gensini score are associated with lower MACE during hospitalization and at 6 months after PCI in acute STEMI patient.These two parameters could thus be used to predict short-term MACE in STEMI patients post PCI.

关 键 词：血小板 GENSINI积分 心肌梗死 预后 

分 类 号：R542.22[医药卫生—心血管疾病]