急性ST段抬高型心肌梗死入院即刻单核细胞与淋巴细胞比值与心血管事件相关性研究  

Relationship between the ratio of admission monocyte to lymphocyte and cardiovascular outcomes in patients with ST-segment elevation myocardial infarction

作　　者：任冬[1] 张芯[1] 刘新林[1] 姬文婕 郭兆增 马永强[1] 石蕊[1] 曾山[1] 刘军翔[1] 赵季红[1] 周欣[1] 李玉明[1] 

机构地区：[1]武警后勤学院附属医院心脏中心武警部队心血管病研究所,天津300162 [2]天津市心血管重塑与靶器官损伤重点实验室,天津300162

出　　处：《中国实用内科杂志》2016年第1期49-52,共4页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金(81170238;81570335);天津市心血管重塑与靶器官损伤重点实验室开放基金(TJC1404;TJC1408)

摘　　要：目的探讨入院即刻单核细胞与淋巴细胞比值（MLR）与接受直接经皮冠状动脉介入（PCI）治疗的急性ST段抬高型心肌梗死（STEMI）患者发病后主要不良心血管事件（MACEs）的相关性。方法连续入选2014年武警后勤学院附属医院心脏中心接受直接PCI治疗的STEMI患者100例，记录发病20个月内MACEs的发生情况，并采用Cox回归模型，分析入院即刻MLR、既往病史、药物治疗等因素与MACEs的关系。结果在武警后勤学院心脏中心连续纳入的100例STEMI患者q-，随访20个月后共有25例患者发生了MACEs（25％），多变量Cox回归分析显示入院MLR（OR1．469，95％CI1．081-1．997，P=0．014）与MACEs的发生显著相关。在校正了传统危险因素后，MLR仍是MACEs发生的独立危险因素（OR1．491，95％CI 1．104-2．011，P=0．009）。以MLR中住数0．28为界，将100例患者分为2组，Kaplan—Meier生存曲线分析显示MLR〉0．28组患者在20个月随访结束时MACEs的发生率高于MLR〈0．28组（P=0．038）。结论STEMI患者入院即刻的MLR是与MACEs发生密切相关的独立危险因素。Objectives To investigate relationship between the admission monocyte to lymphocyte ratio （MLR） and cardiovascular outcomes in patients with ST-segment elevation myocardial infarction （STEMI） undergoing primary percutaneous coronary intervention （PCI）. Methods Consecutive patients admitted with STEMI undergoing PCI treatment were followed up for 20 months from the first occurrence of major adverse cardiovascular events （MACE） use multivariate Cox regression model to analyze the instant MLR on admission, past history, drug therapy and their relationship with MACEs. Results A total of 100 cases of STEMI were enrolled and followed up. During a median follow-up of 20 months, 25 cases of MACEs were recorded. In a univariate Cox regression analysis, MLR（OR： 1.469, 95%Ch 1.081-1.997, P=0.014） was significantly associated with MACEs. After adjustment of conventional risk factors, MLR remained to be the independent predictive factor of MACEs （OR： 1.491, 95% Ch 1.104-2.011, P=0.009）. Using 0.28 as the cutoffpoint value （median of MLR, n=100）, the patients with MLR〉0.28 group had higher MACE incidence than MLR〈0.28 patients in Kaplan-Meier survival analysis （P=0.038） at the end of the 20-month-follow-up. Conclusion Admission MLR is an independent predictor of MACEs in patients with STEMI in a Chinese population.

关 键 词：ST段抬高型心肌梗死 单核淋巴细胞比值 主要不良心血管事件 COX回归分析 

分 类 号：R543.31[医药卫生—心血管疾病]