单核细胞与淋巴细胞比值与ACS患者PCI后临床结局的关系  

Association between the monocyte and lymphocyte ratio and clinical outcome of patients with ACS post-PCI

作　　者：赵翎 唐婧[1,2] 赵倩 李晓梅[1] 高晓明[1,2] ZHAO Ling;TANG Jing;ZHAO Qian;LI Xiaomei;GAO Xiaoming(Department of Cardiology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054;Xinjiang Key Laboratory of Medical Animal Model Research,Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院心脏中心,乌鲁木齐830054 [2]新疆医学动物模型研究重点实验室,乌鲁木齐830054

出　　处：《新疆医科大学学报》2021年第6期691-695,共5页Journal of Xinjiang Medical University

基　　金：国家自然科学基金面上项目(81870272);新疆维吾尔自治区重点实验室开放课题(2017D04003);新疆医科大学研究生创新创业启动基金(CXCY2018040)。

摘　　要：目的探讨经皮冠状动脉介入治疗术(PCI)后单核细胞与淋巴细胞比值(MLR)与急性冠脉综合征(ACS)患者院内主要心血管不良事件(MACE)的关系。方法选取2019年9-12月新疆医科大学第一附属医院收治的ACS并行经皮冠状动脉介入治疗术(PCI)的患者295例。根据院内MACE是否发生分为:未发生院内MACE组(266例)和发生院内MACE组(29例)。根据MLR的推荐截断值将患者分为MLR低比值组(187例)和MLR高比值组(108例)。观察患者院内MACE发生情况;比较患者术后24h内的MLR和其他血常规指标;ROC曲线评估术后MLR对院内MACE的预测能力;Logistic回归分析评估术后MLR预测ACS患者PCI后发生MACE的预测价值。结果对MACE组和非MACE组比较发现,MACE组MLR比非MACE组增高67%(P<0.05);ROC曲线显示MLR预测ACS患者PCI后院内MACE的曲线下面积(AUC)=0.678,P=0.002,截断值为0.45,敏感性为72.4%,特异性为62.8%。MLR低比值组与高比值组比较发现,MLR高比值组MACE发生比低比值组高14%;多因素Logistic回归分析显示,术后MLR是院内MACE的独立预测因子(OR=4.164,95%CI=1.221-14.203,P=0.023)。结论PCI后MLR对ACS患者院内MACE的发生具有预测价值。Objective To investigate the relationship between the monocyte and lymphocyte ratio(MLR)after percutaneous coronary intervention(PCI)and in-hospital major adverse cardiovascular events(MACE)in patients with ACS.Methods A total of 295 ACS patients hospitalized in the First Affiliated Hospital of Xinjiang Medical University who underwent PCI were recruited from September 2019 to December 2019.All 295 ACS patients were divided into MACE group(n=29)and non-MACE group(n=266).Patients were also divided into low MLR group(n=187)and high MLR group(n=108)by cut-off value of MLR.In-hospital MACE after PCI was monitored.Routine blood test within 24 hours after PCI was performed.The predictive value of MLR for in-hospital MACE was assessed by ROC curve and logistic regression analysis.Results The MLR in the MACE group was 67%higher than in the non-MACE group(P<0.05).ROC curve analysis showed that the AUC was 0.678(P=0.002);the cut-off value of MLR was 0.45 with the sensitivity of 72.4%and the specificity of 62.8%,indicating the MLR can predicted in-hospital MACE in the ACS patients after PCI.Moreover,the high MLR group also had a 14%higher incidence of MACE than the low MLR group(P<0.05).Multivariate logistic regression analysis demonstrated that the MLR after PCI was an independent predictor of MACE in the hospital(OR=4.164,95%CI=1.221-14.203,P=0.023).Conclusion The MLR after PCI is able to predict in-hospital MACE in the ACS patients following PCI.

关 键 词：单核细胞与淋巴细胞比值 急性冠脉综合征 经皮冠状动脉介入治疗术 主要心血管不良事件 

分 类 号：R541.4[医药卫生—心血管疾病]