血常规和凝血检测在急性心肌梗死转归期中的临床意义  

The clinical value of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and coagulation parameters in prognostic period of acute myocardial infarction

作　　者：刘晓婷[1] 兰亚婷[1] 向代军[1] 李绵洋[1] 

机构地区：[1]解放军总医院临床检验科,北京100853

出　　处：《中国医学装备》2016年第3期84-87,共4页China Medical Equipment

基　　金：国家重大科学仪器设备开发专项(2012YQ03026107)"核酸定量检测与高分辨分析设备在疾病诊断及生物反恐研究中的应用";全军医学技术研究"十二五"重大专项研究课题(AWS11Z005-4)"师;团快速检验箱组"

摘　　要：目的:探讨血常规和凝血检测在急性心肌梗死(AMI)转归期中的临床意义。方法:选取198例明确诊断为急性心肌梗死且出院的患者,按照心肌梗死溶栓治疗(TIMI)危险评分标准将其分为低分组(98例,得分≤4)与高分组(100例,得分>4)。对所有患者在转归期的血常规、生化指标及凝血参数进行检测分析。结果:1血常规:低分组的血小板(PLT)计数、中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)明显低于高分组,差异有统计学意义(t=45.466,t=15.506,t=636.619;P<0.05),其余指标两组之间相比无差异;2生化指标:低分组和高分组的C反应蛋白(CRP)、胆固醇(TC)、高密度脂蛋白(HDL)、血尿酸(UA)、甘油三酯(TG)、低密度脂蛋白(LDL)及肌钙蛋白T(Tn T)中无统计学差异;3凝血参数:低分组的抗凝血酶Ⅲ(ATⅢ)高于高分组(t=57.869,P<0.05),在凝血酶时间(TT)、活化部分凝血活酶时间(APTT)与纤维蛋白原(FIB)等指标两组间无差异。结论:血常规PLT、PLR和NLR以及凝血联合检测对急性心肌梗死转归期患者有一定的临床价值。Objective： To explore the clinical value of neutrophil /lymphocyte ratio, platelet/lymphocyte ratio and cruor parameters in prognostic period of acute myocardial infarction. Methods： The blood cell parameters, biochemical parameters and cruor parameter in prognostic period of 198 acute myocardial infarction patients were selected. The patients were divided into 2 groups according to TIMI risk scores including lower-group（≤4, n=98） and highergroup（≤4, n=100）. Results： The PLT, NLR and PLR were significantly higher associated with a high TIMI risk score（P=0.014, P=0.041, P=0.001, respectively）, but ATIII was lower at higher-group（P=0.011）. We found that there was no significant difference at CRP, TC, HDL, UA, TG, LDL, Tn T, TT, APTT and FIB level between two groups（P〉0.05）. Conclusion： PLT, PLR, NLR and ATIII play important roles in prognostic period of acute myocardial infarction.

关 键 词：中性粒细胞与淋巴细胞比值 血小板与淋巴细胞比值 凝血参数 急性心肌梗死 转归期 临床价值 

分 类 号：R542.22[医药卫生—心血管疾病]