基于倾向性评分匹配法探讨白细胞/平均血小板体积对STEMI患者急诊PCI术后短期预后的影响  

The effect of white blood cell/mean platelet volume on the short-term prognosis after emergency PCI in patients with STEMI based on propensity score matching

作　　者：李末寒 张弛[2] 许天宝 刘燕荣[4] 陆士奇[1] 吴云[1] LI Mohan;ZHANG Chi;XU Tianbao;LIU Yanrong;LU Shiqi;WU Yun(Department of ICU,The First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China;Department of Cardiology,The First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China;Department of Cardiology,Kezhou People's Hospital Affiliated to Nanjing Medical University;Department of Cardiology,Jiangsu Province Hospital)

机构地区：[1]苏州大学附属第一医院重症医学科,江苏苏州215006 [2]苏州大学附属第一医院心内科 [3]南京医科大学附属克州人民医院心内科 [4]江苏省人民医院心内科

出　　处：《临床心血管病杂志》2021年第6期516-519,共4页Journal of Clinical Cardiology

摘　　要：目的:探讨白细胞/平均血小板体积(WMR)与接受急诊经皮冠状动脉介入术(PCI)的急性ST段抬高型心肌梗死(STEMI)患者术后30 d内主要心血管不良事件(MACE)发生情况的关系。方法:收集2018年1月—2019年1月就诊于苏州大学附属第一医院的586例STEMI患者以及2019年7月—2020年4月南京医科大学附属克州人民医院的86例STEMI患者入院时的临床资料。以同时期健康体检者的WMR的中位数(0.57)为界限,将患者分为WMR高值组和WMR低值组,使用倾向性评分匹配法(PSM)均衡两组患者其他临床指标的组间差异,对进行PSM后的临床资料进行Cox回归分析,并绘制生存曲线。结果:PSM后WMR高值组的MACE发生率高于WMR低值组(23.08%∶39.74%,P=0.038),PSM后的Cox回归分析显示,WMR是患者PCI术后30 d内发生MACE的独立危险因素(OR=2.677,95%CI:1.417~5.057,P=0.002)。结论:PSM可以提高回归性研究数据之间的可比性及结果的可信度,经PSM减轻其他临床资料在组间分布不均衡的混杂影响后,WMR仍是STEMI患者短期不良预后的独立危险因素。Objective:To explore the effect of white blood cell/mean platelet volume(WMR)on the occurrence of major cardiovascular adverse events(MACE)within 30 days after emergency PCI in patients with acute ST segment elevation myocardial infarction(STEMI).Methods:Totally 586 patients with STEMI who were admitted to the First Affiliated Hospital of Soochow University from January 2018 to January 2019 and 86 STEMI patients from Kezhou People’s Hospital Affiliated to Nanjing Medical University from July 2019 to April 2020 were collected.All patients were divided into high-WMR group and low-WMR group according to the median WMR(0.57)in health people in the same period.The propensity score matching method was used to balance differences of other clinical data between the two groups,Cox regression analysis was performed on the clinical data after PSM and survival curves were drawn.Results:The incidence of MACE in the high-WMR group after PSM was higher than that in the low-WMR group(23.08%∶39.74%,P=0.038).Cox regression analysis after PSM showed that WMR was an independent risk factor for MACE within 30 days after PCI(OR=2.677,95%CI:1.417-5.057,P=0.002).Conclusion:After PSM reducing the confounding influence of the uneven distribution of other clinical data between groups,PSM can improve the comparability of regression study data and the credibility of the results.WMR is still an independent risk factor for short-term poor prognosis in patients with STEMI.

关 键 词：急性ST段抬高型心肌梗死 白细胞/平均血小板体积 预后 倾向性评分匹配 

分 类 号：R542.2[医药卫生—心血管疾病]