平均血小板体积联合SYNTAX积分评估介入治疗非ST段抬高心肌梗死患者远期预后的价值  

Prognostic value of mean platelet volume and SYNTAX score on predicting long-term outcome in patients with acute non-ST segment elevation myocardial infarction undergone percutaneous coronary intervention

作　　者：徐海燕[1] 陈雨[1] 蒙涛[1] 马树人[1] 谢雄伟[1] 

机构地区：[1]南京医科大学附属淮安第一医院心内科,江苏省淮安市223300

出　　处：《中国心血管病研究》2015年第9期831-835,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨平均血小板体积（MPV）联合SYNTAX评分对急性非ST段抬高心肌梗死（NSTEMI）患者经皮冠状动脉介入（PCI）术后远期预后的评估价值.方法 选取2012年1月至2013年12月在南京医科大学附属淮安第一医院诊断为NSTEMI并接受PCI治疗的患者158例,测定MPV水平及计算SYNTAX评分.随访12个月,根据随访结果分为心血管事件组和无心血管事件组,分析两组MPV水平、SYNTAX评分与心血管事件的关系.MPV联合SYNTAX评分预测主要不良心血管事件（MACE）效能用受试者工作特征（ROC）曲线下面积评价.结果 心血管事件组MPV水平、SYNTAX评分均高于无心血管事件组,差异具有统计学意义（P=-0.025,P=0.021）.多因素Cox回归分析显示,MPV和SYNTAX评分是远期发生心血管事件的独立预测因子.MPV联合SYNTAX评分预测NSTEMI患者PCI术后1年发生MACE的ROC曲线下面积为0.713 （95％CI 0.615～0.811,P=0.001）.将MPV水平10.55 fl、SYNTAX评分31分作为危险分层界值,绘制Kaplan-Meier生存曲线显示,高危组与低危组两组间发生主要不良心血管事件差异具有统计学意义（P=0.006）.结论 MPV与SYNTAX联合评分对急性非ST段抬高心肌梗死患者PCI术后远期预后评估有一定的价值.Objective To explore the value of mean platelet volume （MPV） and SYNTAX score on predicting long-term outcome in patients with non-ST segment elevation acute myocardial infarction （NSTEMI） undergoing percutaneous coronary intervention（PCI）. Methods A total of 158 NSTEMI patients undergone PCI in our hospital from January 2009 to December 2013 were investigated. The plasma levels of MPV were recorded. The SYNTAX score was calculated according to the results of coronary angiography. Incidence of major adverse cardiac events （MACE） 12 months after PCI was observed. The forecast performance of MPV plus SYNTAX score was evaluated by using receiver operating characteristic （ROC） curves and area under curves （AUC）. Results Compared with no MACE group, the MACE group had higher level of MPV and SYNTAX score （P=0.025, P= 0.021 ）. Cox regression analysis suggested that the level of MPV and SYNTAX score were independent predictors of 12-month MACE in patients undergoing PCI. According to ROC curve analysis, MPV plus SYNTAX score for predicting major adverse cardiovascular events （MACE） occurrence in NSTEMI patients at 12 months post PCI was 0.713 （95%CI 0.615-0.811, P=0.001 ）. Taking MPV 10.55 fl and SYNTAX score 31 as the cut-off point for risk stratification, the Kaplan-Meier survival curve revealed significant difference between high risk and low risk patients for MACE occurrence in NSTEMI patients （P=0.006）. Conclusion MPV combined with SYNTAX score could be used to predict long-term MACE in NSTEMI patients post PCI.

关 键 词：平均血小板体积 急性非ST段抬高心肌梗死 SYNTAX评分 

分 类 号：R542.22[医药卫生—心血管疾病]