血小板与淋巴细胞比值评估合并多支血管病变的急性心肌梗死患者预后的价值  

The value of platelet to lymphocyte ratio in evaluating the prognosis of patients with acute myocardial infarction combined with multivessel disease

作　　者：郝增光[1] 韩兆帅 葛慧敏[1] HAO Zeng-guang;HAN Zhao-shuai;GE Hui-min(Department of Cardiovascular Medicine(Ⅱ),Anyang District Hospital of Puyang City,Anyang 455000,China)

机构地区：[1]濮阳市安阳地区医院心内二科,安阳455000

出　　处：《天津医科大学学报》2021年第2期150-154,共5页Journal of Tianjin Medical University

摘　　要：目的:探讨血小板与淋巴细胞比值(PLR)对合并多支血管病变的急性心肌梗死患者远期预后价值。方法:收集2010年1月—2014年5月在安阳地区医院接受经皮冠状动脉介入(PCI)治疗的合并多支血管病变的急性心肌梗死患者216例,根据PLR预测患者5年后死亡的临界值,将患者分为高PLR组和低PLR组,比较两组患者的5年随访结果,主要包括全因死亡、心源性死亡、不良心脑血管事件(MACCE)、血运重建、支架内血栓、再发心肌梗死、再发脑卒中和出血。多因素Logistic回归模型分析影响MACCE和患者预后的危险因素。结果:PLR预测患者5年后死亡的临界值为164,高PLR组94例,低PLR组122例。高PLR组全因死亡、心源性死亡和MACCE的发生率均高于低PLR组(χ^(2)=4.744、4.484、4.476,均P<0.05);高PLR组5年存活率81.9%,明显低于低PLR组的96.7%(P<0.001);年龄(OR=2.312,95%CI:1.005~4.315)、左室射血分数(OR=1.217,95%CI:2.743~9.657)和PLR(OR=1.108,95%CI:1.638~6.256)为患者发生MACCE的独立危险因素(均P<0.05);高PLR为患者发生全因死亡(OR=0.132,95%CI:0.045~2.143)、心源性死亡(OR=1.459,95%CI:0.725~3.632)和MACCE(OR=5.413,95%CI:2.205~8.314)的独立危险因素(均P<0.05)。结论:高PLR影响患者的5年存活率且为合并多支血管病变的急性心肌梗死患者远期全因死亡和MACCE发生的独立危险因素,对合并多支血管病变的急性心肌梗死患者预后具有一定的临床预测价值。Objective:To investigate the long-term prognostic value of platelet to lymphocyte ratio(PLR)in patients with acute myocardial infarction combined with multivessel disease.Methods:A total of 216 acute myocardial infarction patients with multivessel disease who received percutaneous coronary intervention(PCI)treatment in Anyang District Hospital from 2010 to 2014 were collected.According to the critical value of PLR predicting the death of patients after 5 years,the patients were divided into high PLR group and low PLR group,and the 5-year follow-up results of the two groups were compared,mainly including all-cause death,cardiac death,adverse cardiovascular and cerebrovascular events(MACCE),revascularization,stent thrombosis,recurring myocardial infarction,recurring stroke and hemorrhage.Multivariate Logistic regression model was used to analyze the risk factors that affected MACCE and the prognosis of patients.Results:The critical value of PLR predicting patient death after 5 years was 164,there were 94 cases in high PLR group,122 cases in low PLR group.The incidences of all-cause death,cardiogenic death and MACCE in the high PLR group were higher than those in the low PLR group(χ^(2)=4.744,4.484,4.476,all P<0.05).The 5-year survival rate of the high PLR group was 81.9%,which was significantly lower than that of the low PLR group(96.7%,P<0.001).Age(OR=2.312,95%CI:1.005-4.315),left ventricular ejection fraction(OR=1.217,95%CI:2.743-9.657)and PLR(OR=1.108,95%CI:1.638-6.256)were independent risk factors for MACCE(all P<0.05).High PLR was an independent risk factor for all-cause death(OR=0.132,95%CI:0.045-2.143),cardiac death(OR=1.459,95%CI:0.725-3.632)and MACCE(OR=5.413,95%CI:2.205,8.314,all P<0.05).Conclusion:High PLR affects the 5-year survival rate of patients and is an independent risk factor for long-term all-cause death and MACCE in patients with acute myocardial infarction with multivessel disease.It has a predictive value for clinical prognostic of patients with acute myocardial infarction with multivessel d

关 键 词：急性心肌梗死 多支血管病变 血小板 淋巴细胞 急性冠脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]