中性/淋巴细胞比值、超敏肌钙蛋白I联合CHA_(2)DS_(2)-VAS_(C)评分与非ST段抬高型心肌梗死患者罪犯血管完全闭塞的相关性  

Correlation between neutral/lymphocyte ratio,high-sensitivity troponin I combined with CHA_(2)DS_(2)-VAS_(C)score and complete vascular occlusion of criminals in patients with non-ST-segment elevation myocardial infarction

作　　者：石同欢 孔彬[1] 帅维 黄鹤[1] Shi Tonghuan;Kong Bin;Shui Wei;Huang He(Department of Cardiology,Renmin Hospital of Wuhan University,Cardiovascular Research Institute of Wuhan University,Hubei Key Laboratory of Cardiology,Hubei Province,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院心内科/武汉大学心血管病研究所/心血管病湖北省重点实验室,430060

出　　处：《疑难病杂志》2021年第1期2-6,12,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：国家重点研发计划项目(2017YFC1700504)。

摘　　要：目的分析外周血中性粒细胞/淋巴细胞比值(NLR)、超敏肌钙蛋白I(ultra-TnI)联合CHA_(2)DS_(2)-VAS_(C)评分与非ST段抬高型心肌梗死(NSTEMI)患者罪犯血管完全闭塞的相关性。方法选取2018年2月—2019年12月于武汉大学人民医院心血管内科住院的161例NSTEMI患者为研究对象,收集患者临床资料及入院后的辅助检查结果,并进行CHA_(2)DS_(2)-VAS_(C)评分,分析各指标间的相关性。结果161例NSTEMI患者中,罪犯血管完全闭塞组51例(31.7%),非完全闭塞组110例(68.3%),完全闭塞组患者的NLR、ultra-TnI水平和CHA_(2)DS_(2)-VAS_(C)评分高于非完全闭塞组,差异均有统计学意义(Z/P=4.846/<0.001、3.374/<0.001、3.680/<0.001)。NLR、ultra-TnI、CHA_(2)DS_(2)-VAS_(C)评分、冠心病史是NSTEMI患者罪犯血管完全闭塞的危险因素[OR(95%CI)=1.521(1.555~2.002)、1.046(1.010~1.083)、1.427(1.088~1.872)、3.343(1.185~9.431)]。NLR、ultra-TnI、CHA_(2)DS_(2)-VAS_(C)评分及三者联合对NSTEMI患者罪犯血管完全闭塞预测的ROC曲线下面积分别为0.738、0.666、0.677、0.789。结论NLR、ultra-TnI联合CHA_(2)DS_(2)-VAS_(C)评分对非ST段抬高型心肌梗死患者罪犯血管完全闭塞具有一定的预测价值,可用于患者术前评估及确定治疗策略,以提高手术成功率和改善患者预后。Objective To analyze the correlation between peripheral blood neutrophil/lymphocyte ratio(NLR),high-sensitivity troponin I(ultra-TnI)combined with CHA_(2)DS_(2)-VAS_(C)score and total occlusion of culprit vessels in patients with non ST segment elevation myocardial infarction(NSTEMI).Methods One hundred and sixty one patients with NSTEMI who were hospitalized in the Department of Cardiovascular Medicine,Wuhan University People's Hospital from February 2018 to December 2019 were selected as the research objects.Collect patient clinical data and auxiliary examination results after admission.And perform CHA_(2)DS_(2)-VAS_(C)scoring to analyze the correlation between the indicators.Results Among the 161 patients with NSTEMI,51 cases(31.7%)in the culprit vascular complete occlusion group and 110 cases(68.3%)in the incomplete occlusion group.The NLR,ultra-TnI levels and CHA_(2)DS_(2)-VAS_(C)scores of the patients in the complete occlusion group were higher than those in the incomplete occlusion group.All were statistically significant(Z/P=4.846/<0.001,3.374/<0.001,3.680/<0.001).NLR,ultra-TnI,CHA_(2)DS_(2)-VAS_(C)score,and history of coronary heart disease are risk factors for complete vascular occlusion of offenders in NSTEMI patients[OR(95%CI)=1.521(1.550~2.002),1.046(1.010~1.083),1.427(1.088~1.827),3.343(1.185~9.431)].The area under the ROC curve predicted by the NLR,ultra-TnI,CHA_(2)DS_(2)-VAS_(C)scores and the combination of the three for complete vascular occlusion of criminals in NSTEMI patients were 0.738,0.666,0.677,0.789,respectively.Conclusion NLR,ultra-TnI combined with CHA_(2)DS_(2)-VAS_(C)scores have a certain predictive value for complete vascular occlusion of offenders in patients with non-ST-segment elevation myocardial infarction.They can be used for preoperative evaluation of patients and determination of treatment strategies to improve surgical success rate and improve patient prognosis.

关 键 词：心肌梗死 非ST段抬高型 中性粒细胞/淋巴细胞比值 超敏肌钙蛋白I CHA_(2)DS_(2)-VAS_(C)评分 罪犯血管 完全闭塞 相关性 

分 类 号：R542.2[医药卫生—心血管疾病]