急性前壁心肌梗死左心室血栓形成的影响因素  

Influencing factors of left ventricular thrombosis in acute anterior wall myocardial infarction

作　　者：刘泽宇 冯应君[1] 刘宣宣 LIU Zeyu;FENG Yingjun;LIU Xuanxuan(Department of Physical Diagnostics,Yuebei People′s Hospital,Guangdong Province,Shaoguan512026,China;Department of Cardiology,Yuebei People′s Hospital,Guangdong Province,Shaoguan512026,China)

机构地区：[1]广东省粤北人民医院物理诊断科,广东韶关512026 [2]广东省粤北人民医院心血管内科,广东韶关512026

出　　处：《中国当代医药》2022年第28期99-102,共4页China Modern Medicine

摘　　要：目的探讨急性前壁心肌梗死患者左心室血栓(LVT)形成的影响因素。方法回顾性分析2017年4月至2021年4月粤北人民医院收治的132例急性前壁心肌梗死患者的临床资料,根据是否发生LVT分为血栓组(n=46)与非血栓组(n=86)。采用logistic回归分析影响LVT形成的因素,采用ROC曲线分析中性粒细胞淋巴细胞比值(NLR)预测LVT的价值。结果单因素分析结果显示,室壁瘤比例、白细胞计数(WBC)、中性粒细胞计数(NEU)、NLR、血小板淋巴细胞比值(PLR)、单核细胞淋巴细胞比值(MLR)升高、经皮冠脉介入术(PCI)<12 h、左室射血分数(LVEF)、淋巴细胞计数(LYM)、白蛋白(Alb)水平下降与急性前壁心肌梗死后LVT形成有关,差异有统计学意义(P<0.05);多因素logistic回归模型分析结果显示,室壁瘤形成(β=2.028,OR=7.602,95%CI=2.003~28.857)、Alb下降(β=0.152,OR=1.165,95%CI=1.015~1.337)是急性前壁心肌梗死后发生LVT的独立危险因素(P<0.05);ROC曲线显示NLR预测急性前壁心肌梗死后左室血栓形成的最佳截点为8.071,ROC曲线下面积为0.751,其灵敏度为0.587,特异度为0.837。结论室壁瘤形成、白蛋白水平下降是急性前壁心肌梗死发生LVT的独立危险因素;且NLR与LVT发生有关,随着NLR水平升高,LVT发生风险增加。Objective To investigate the influencing factors of left ventricular thrombosis(LVT)in patients with acute anterior wall myocardial infarction.Methods Clinical data of 132 patients with acute anterior wall myocardial infarction confirmed in Yuebei People′s Hospital from April 2017 to April 2021 were retrospectively analyzed.They were divided into the thrombus group(n=46)and the non-thrombus group(n=86)according to the occurrence of LVT.Logistic regression was used to analyze the factors affecting LVT formation,and ROC curve was used to analyze the value of neutrophil lymphocyte ratio(NLR)in predicting LVT.Results Univariate analysis showed that the increase of ventricular aneurysm ratio,White blood cells(WBC),neutrophil count(NEU),NLR,platelet lymphocyte ratio(PLR),monocyte lymphocyte ratio(MLR),percutaneous coronary intervention(PCI),left ventricular ejection fraction(LVEF),lymphocyte count(LYM)and albumin(ALB)were related to the formation of LVT after acute anterior wall myocardial infarction,There was significant difference(P<0.05).Multivariate logistic regression analysis showed that the formation of ventricular aneurysm(β=2.028,OR=7.602,95%CI=2.003-28.857),Alb decreased(β=0.152,OR=1.165,95%CI=1.015-1.337)was an independent risk factor for LVT after acute anterior wall myocardial infarction(P<0.05).ROC curve showed that the optimal cut-off point of NLR for predicting left ventricular thrombosis after acute anterior wall myocardial infarction was 8.071,the area under ROC curve was 0.751,and its sensitivity was 0.587 and specificity was 0.837.Conclusions The formation of ventricular aneurysm and decreased albumin level were independent risk factors for LVT in acute anterior wall myocardial infarction.NLR is related to the occurrence of LVT,and the risk of LVT increases with the increase of NLR level.

关 键 词：急性前壁心肌梗死 左心室血栓 中性粒细胞淋巴细胞比值 室壁瘤 

分 类 号：R542.2[医药卫生—心血管疾病]