中性粒细胞与淋巴细胞比值在急性心肌梗死PCI术中无复流和术后MACE中的预测价值  

Predictive value of neutrophils to lymphocytes ratio for no reflow during PCI and postoperative MACE in AMI patients

作　　者：余辉 李宾[1] 甘受益[1] 葛雄[1] 黎昭 刘亮 郑恒 YU Hui;LI Bin;GAN Shou-yi;GE Xiong;LI Zhao;LIU Liang;ZHENG Heng(Department of Cardiology,Central Hospital of Xianning City,Xianning,Hubei,437000,China)

机构地区：[1]咸宁市中心医院湖北科技学院附属第一医院心内科,湖北咸宁437000

出　　处：《心血管康复医学杂志》2020年第4期458-462,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探究中性粒细胞与淋巴细胞比值(NLR)对急性心肌梗死(AMI)经皮冠状动脉介入(PCI)术中无复流和术后主要不良心血管事件(MACE)的预测价值.方法:选择本院行PCI术治疗的220例AMI患者为研究对象,根据在PCI术中是否出现冠脉复流分为复流组(174例)与无复流组(46例),对比两组患者的临床资料、手术情况及血液指标,分析NLR值对无复流的预测价值.根据术后1年随访是否出现MACE,患者被分为事件组(198例)与无事件组(22例),分析NLR对MACE的预测价值.结果:与复流组比较,无复流组再灌注时间[(4.57±2.35)h比(6.48±2.72)h]、中性粒细胞百分比[(63.48±9.54)%比(70.45±12.68)%]及NLR[(1.77±0.42)比(3.89±1.65)]均显著增加,淋巴细胞百分比[(27.20±7.14)%比(21.97±10.08)%]显著减小(P均=0.001).术后随访1年,与无事件组比较,事件组NLR值显著升高[(1.84±0.38)比(4.72±1.46),P=0.001].结论:NLR与AMI患者PCI术中无复流及术后MACE事件有一定的关联性,高NLR预示着AMI患者具有更高的术中无复流与术后MACE的风险.Objective:To explore predictive value of neutrophils to lymphocytes ratio(NLR) for no reflow during percutaneous coronary intervention(PCI) and postoperative major adverse cardiovascular events(MACE) in patients with acute myocardial infarction(AMI). Methods:A total of 220 AMI patients undergoing PCI in our hospital were selected. According to presence of coronary reflow during PCI, they were divided into reflow group(n=174) and no reflow group(n=46). Clinical data, PCI condition and blood indexes were compared between two groups, and predictive value of NLR for no reflow was analyzed. According to presence of MACE within one-year follow-up after PCI, they were divided into event group(n=198) and no event group(n=22), and predictive value of NLR for MACE was analyzed. Results:Compared with reflow group, there were significant rise in reperfusion time [(4.57±2.35)h vs.(6.48±2.72)h], percentages of neutrophils [(63.48±9.54)% vs.(70.45±12.68)%] and NLR [(1.77±0.42) vs.(3.89±1.65)], and significant reduction in percentage of lymphocytes [(27.20±7.14)% vs.(21.97±10.08)%] in no reflow group, P=0.001 all. Compared with no event group after one-year follow-up, there as significant rise in NLR [(1.84±0.38) vs.(4.72±1.46)] in event group, P=0.001. Conclusion:NLR is associated with no reflow during PCI and postoperative MACE to some extent in AMI patients. High NLR suggests higher risk of no reflow during PCI and postoperative MACE in AMI patients.

关 键 词：心肌梗死 血管成形术 气囊 冠状动脉 中性白细胞 淋巴细胞 

分 类 号：R542.22[医药卫生—心血管疾病]