术前Lp-PLA2、PLR联合术后HPR预测AMI患者PCI术后半年内MACE的价值  

Preoperative Lp-PLA2 and PLR combined with postoperative HPR predicts the value of MACE within six months after PCI in AMI patients

作　　者：朱晓明 黄勇先 ZHU Xiaoming;HUANG Yongxian(Wuxi Branch of Zhongda Hospital Affiliated to Southeast University,Wuxi,Jiangsu,China,214000)

机构地区：[1]东南大学附属中大医院无锡分院,江苏无锡214000

出　　处：《分子诊断与治疗杂志》2021年第11期1779-1782,共4页Journal of Molecular Diagnostics and Therapy

基　　金：无锡市卫生计生委科研项目(Q201823)。

摘　　要：目的探讨术前脂蛋白相关磷脂酶A2(Lp-PLA2)、血小板计数与淋巴细胞计数比值(PLR)联合术后血小板高反应性(HPR)预测急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后半年内心血管不良事件(MACE)的价值。方法选取2018年8月至2020年6月于东南大学附属中大医院无锡分院接受PCI手术的102例急性心肌梗死患者,PCI术后随访6个月,根据患者是否发生MACE分为MACE组和非MACE组。比较两组Lp-PLA2、PLR、HPR水平,分析影响急性心肌梗死患者PCI术后MACE发生的独立危险因素。结果MACE组Lp-PLA2、PLR水平和HPR比例均明显高于非MACE组,差异均有统计学意义(P<0.05)。非条件多因素logistic回归模型分析显示,年龄(≥65岁)、有心衰病史、Lp-PLA2(异常升高)、PLR(异常升高)、HPR为影响急性心肌梗死患者PCI术后MACE事件发生的独立危险因素(P<0.05)。结论术前Lp-PLA2、PLR水平及术后HPR为影响患者预后的独立危险因素,通过检测三者可为AMI患者PCI术后半年内MACE事件提供有效的预测信息,以采取积极预防措施,改善患者预后。Objective To explore the value of preoperative lipoprotein associated phospholipase A2(Lp-PLA2),platelet to lymphocyte ratio(PLR)combined with postoperative high platelet reactivity(HPR)predicting major adverse cardiovascular events(MACE)of patients with acute myocardial infarction(AMI)after PCI in six months.Methods 102 patients with acute myocardial infarction who were treated with PCI surgery in Wuxi Branch of Zhongda Hospital Affiliated to Southeast University from August 2018 to June2020 were selected.The patients were followed up for 6 months after PCI.According to whether the patients had MACE or not,they were divided into the MACE group and the non-MACE group.The levels of Lp-PLA2,PLR,and HPR in the two groups were compared,and the independent risk factors that affected the occurrence of MACE events after PCI in patients with acute myocardial infarction were analyzed.Results The levels of Lp-PLA2,the PLR and HPR ratio in the MACE group were significantly higher than those in the non-MACE group.The difference was statistically significant(P<0.05).Analysis of unconditional multivariate logistic regression model showed that age(≥65),history of heart failure,Lp-PLA2(abnormal increase),PLR(abnormal increase),and HPR were independent risk factors that affect MACE events after PCI in patients with acute myocardial infarction(P<0.05).Conclusion The preoperative Lp-PLA2,PLR levels and postoperative HPR are independent risk factors that affect the prognosis of patients.The detection of the three can provide effective predictive information for MACE events within six months after PCI in AMI patients,to take active preventive measures and improve the patient.s prognosis.

关 键 词：急性心肌梗死 冠状动脉介入治疗术 血管不良事件 脂蛋白酶相关磷脂酶A2 血小板计数与淋巴细胞计数比值 

分 类 号：R542.22[医药卫生—心血管疾病]