高NLR、Killip分级、PCI术后无复流对急性ST段抬高心肌梗死患者长期预后的影响  

Effect of high NLR,Killip grading and no re-flow after PCI on long-term prognosis in patients with acute ST-segment elevation myocardial infarction

作　　者：陈厚良 高彦琳 董玲玲 丁汝跃[1] 钟万生 潘文博[1] CHEN Hou-liang;GAO Yan-lin;DONG Ling-ling;DING Ru-yue;ZHONG Wan-sheng;PAN Wen-bo(Hefei the Third People's Hospital,Hefei 230000,China)

机构地区：[1]合肥市第三人民医院,安徽合肥230000 [2]安徽省第二人民医院,安徽合肥230000

出　　处：《武警后勤学院学报（医学版）》2019年第11期44-48,共5页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】通过分析中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)与急性ST段抬高心肌梗死(STsegment elevation myocardial infarction,STEMI)患者急诊经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术前术后相关指标的关系,并通过随访1年内患者心血管不良(MACE)事件,判断NLR对STMEI患者PCI术后长期的影响。【方法】通过收集2016年3月至2018年3月在本院行急诊PCI的STEMI患者(111例)资料;按照NLR中位数数值(NLR=2.9)高低分为两组,对比两组患者的临床基本特点;并以随访1年内的MACE事件为因变量,对相关数据行Logistic回归分析。【结果】两组患者左室射血分数(left ventricular ejection fraction,LVEF)、C反应蛋白(C-reactive protein,CRP)、术后出现无复流(TIMI≤2级)、急性心梗所致心力衰竭的临床分级(Killip分级,Killip≥Ⅲ级)、1年内总MACE事件之间差异有统计学意义(P<0.05),多因素Logistic回归分析:可见NLR是1年内MACE事件发生的危险因素。【结论】入院时高NLR提示患者1年内MACE事件发生率高,患者预后不良,有利于指导STEMI早期危险程度分层。【Objective】To determine the long-term effect of neutrophil-to-lymphocyte ratio(NLR)in patients with ST-segment elevation myocardial infarction(STMEI)after PCI by analyzing the relationship between the NLR and relevant indicators before and after emergency percutaneous coronary intervention(PCI)in patients with acute STEMI,and following up MACE events for 1 year.【Methods】The STEMI patients undergoing emergency PCI in our hospital were enrolled from March 2016 to March 2018(112 cases).According to the median value of NLR(NLR=2.9),they were divided into two groups.The clinical characteristics between the two groups were compared.MACE events within 1 year of follow-up were used as the dependent variable,and the related data were analyzed by Logistic regression analysis.【Results】There were statistically significant differences in left ventricular ejection fraction(LVEF),creactive protein(CRP),postoperative non-reflow(TIMI≤level 2),Killip grading(Killip≥levelⅢ)and total MACE events within 1 year between the two groups(P<0.05).Multivariate Logistic regression analysis showed that NLR was a risk factor for MACE events within 1 year.【Conclusion】High NLR indicates a high incidence of MACE events within 1 year and poor prognosis,which is conducive to guiding the stratification of early risk of STEMI.

关 键 词：急性ST段抬高心肌梗死 中性粒细胞/淋巴细胞比值 心血管不良事件 无复流 KILLIP分级 

分 类 号：R542.2[医药卫生—心血管疾病]