白细胞/血小板比值联合心肌梗死溶栓治疗临床试验评分评估急性心肌梗死患者预后的价值  

The value of white blood cell/platelet ratio combined with thrombolysis in myocardial infarction risk score in evaluating the prognosis of patients with acute myocardial infarction

作　　者：吴灿涛 林丹妮 郭贵湿 WU Cantao;LIN Danni;GUO Guishi(Department of Emergency,Guangdong Yanling Hospital,Guangzhou,Guangdong,510000,China;Department of Geriatrics,Guangdong Yanling Hospital,Guangzhou,Guangdong,510000,China)

机构地区：[1]广东燕岭医院急诊科,广东广州510000 [2]广东燕岭医院老年病科,广东广州510000

出　　处：《当代医学》2022年第22期152-155,共4页Contemporary Medicine

摘　　要：目的探讨白细胞/血小板比值(WMR)联合心肌梗死溶栓治疗临床试验(TIMI)评分评估急性心肌梗死患者预后的价值。方法回顾性分析2016年1月至2019年6月本院收治的200例急性心肌梗死患者的临床资料,所有患者均行溶栓治疗,根据TIMI危险评分结果分为低危险组(<3分,n=128)、中危组(4~6分,n=48)与高危组(7~40分,n=24),根据WMR值分为WMR低值组(≤0.9411,n=132)与WMR高值组(>0.9411,n=68),比较不同WMR值急性心肌梗死患者预后、不同TIMI危险评分急性心肌梗死患者预后,分析WMR和TIMI单项和联合评估对急性心肌梗死患者预后不良的预测价值。结果WMR高值组预后不良事件发生率为45.59%,高于WMR低值组的28.79%,差异有统计学意义(P<0.05)。高危组预后不良事件发生率为87.50%,高于低危组与中危组的25.78%、31.25%,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,WMR和TIMI单项的AUC分别为0.844和0.748,95%CI分别为0.787~0.812和0.802~0.874,P=0.011。WMR+TIMI的AUC为0.912,95%CI为0.841~0.954,P=0.001;其中WMR和TIMI联合预测心肌梗死预后的灵敏度、准确率均明显高于单项指标,差异有统计学意义(P<0.05)。结论相对TIMI危险评分单一项指标,WMR联合TIMI更能提高对急性心肌梗死患者预后的预测价值,对指导临床治疗方案的制订具有重要意义。Objective To investigate the value of white blood cell/platelet ratio(WMR)combined with thrombolysis in myocardial infarction(TIMI)score in evaluating the prognosis of patients with acute myocardial infarction.Methods The clinical data of 200 patients with acute myocar-dial infarction admitted to our hospital from January 2016 to June 2019 were retrospectively analyzed.All patients received thrombolytic therapy and were divided into low-risk groups(<3 scores,n=128),intermediate-risk group(4-6 scores,n=48)and high-risk group(7-40 scores,n=24)according to the TIMI risk score,they were divided into low WMR value group(≤0.9411,n=132)and the high WMR value group(>0.9411,n=68)according to the WMR value,the prognosis of patients with acute myocardial infarction with different WMR values and the prognosis patients with acute myo-cardial infarction with different TIMI risk scores were compared,and the predictive value of WMR and TIMI single and combined assessments for poor prognosis in patients with acute myocardial infarction were analyzed.Results The total incidence of adverse events in the high WMR value group was 45.59%,which was higher than 28.79%in the low WMR value group,and the difference was statistically significant(P<0.05).The inci-dence of adverse events in the high-risk group was 87.50%,which was higher than 25.78%and 31.25%in the low-risk group and the intermediate risk group,and the difference was statistically significant(P<0.05).The results of ROC curve analysis showed that the AUC of WMR and TIMI were 0.844 and 0.748,respectively,and the 95%CI were 0.787-0.812 and 0.802-0.874,respectively,P=0.011.The AUC of WMR+TIMI was 0.912,the 95%CI was 0.841-0.954,P=0.001;the sensitivity and accuracy of the combined WMR and TIMI in predicting the prognosis of myocardial infarc-tion were significantly higher than those of the single index,and the difference was statistically significant(P<0.05).Conclusion Compared with the single index of TIMI risk score,WMR combined with TIMI can better predict the prognosis of pa

关 键 词：白细胞/血小板比值 TIMI危险评分 急性心肌梗死 预后 

分 类 号：R542.22[医药卫生—心血管疾病]