血小板相关实验室指标预测老年经皮冠状动脉介入术后患者主要心血管不良事件的价值  

Value of platelet-related laboratory indicators in predicting major adverse cardiovascular events of elderly patients after percutaneous coronary intervention

作　　者：张翥 范修才 陶亮亮 祁建成 ZHANG Zhu;FAN Xiucai;TAO Liangliang;QI Jiancheng(Department of Cardiology,Jianhu Clinical Medical College of Yangzhou University,Jianhu,Jiangsu,224700)

机构地区：[1]扬州大学建湖临床医学院心血管内科,江苏建湖224700

出　　处：《实用临床医药杂志》2022年第24期86-89,106,共5页Journal of Clinical Medicine in Practice

基　　金：2021江苏省盐城巿科技计划项目(YK2021082)。

摘　　要：目的探讨血小板聚集率(PAG)、血小板膜糖蛋白(GP)等实验室指标预测老年经皮冠状动脉介入术(PCI)后患者主要心血管不良事件(MACE)风险的价值。方法选取行PCI的冠心病患者108例,评估并记录患者PCI后6个月内MACE发生情况,并将患者分为MACE组(n=17)和无MACE组(n=91)。比较2组患者PAG、GPⅡb/Ⅲa纤维蛋白原受体(PAC-1)、P-选择素(CD62P)及其他相关实验室指标[血小板计数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)、凝血酶原时间(PT)、血肌酐(Scr)、总胆固醇(TC)];采用受试者工作特征(ROC)曲线分析PAG、PAC-1、CD62P、PT、Scr预测MACE的价值,采用多因素Logistic回归分析法分析MACE的危险因素。结果MACE组年龄>70岁、病变血管≥3支患者比率高于无MACE组,PAG、PAC-1、CD62P、Scr水平高于无MACE组,左室射血分数(EF)、PT低于无MACE组,差异均有统计学意义(P<0.05)。ROC曲线分析显示,PAG、PAC-1、CD62P、PT、Scr预测MACE的曲线下面积分别为0.895、0.894、0.806、0.937、0.672。多因素Logistic回归分析显示,年龄>70岁、病变血管≥3支、EF<53%、PAG>43.155%、PAC-1>15.560%、CD62P>15.100%、PT<14.975 s、Scr>83.810μmol/L均为MACE的危险因素(P<0.05)。结论高水平PAG、GP、PAC-1、CD62P、Scr及低水平PT、EF均为冠心病患者PCI后MACE的危险因素。Objective To explore the values of platelet aggregation rate(PAG),platelet membrane glycoprotein(GP)and other laboratory indicators in predicting risk of major adverse cardiovascular events(MACE)in elderly patients after percutaneous coronary intervention(PCI).Methods A total of 108 coronary heart disease patients with PCI were selected,the incidence of MACE within 6 months after PCI was evaluated and recorded,and the patients were divided into MACE group(n=17)and no MACE group(n=91).PAG,GPⅡb/Ⅲa fibrinogen receptor(PAC-1),P-selectin(CD62 P)and other related laboratory indexes[platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW),prothrombin time(PT),serum creatinine(Scr),and total cholesterol(TC)]were compared between the two groups;the receiver operating characteristic(ROC)curve was used to analyze the values of PAG,PAC-1,CD62 P,PT and Scr in predicting MACE,and the multivariate Logistic regression analysis was used to analyze the risk factors of MACE.Results The ratios of patients with age>70 years old and diseased vessels≥3 in the MACE group were significantly higher than those in the no MACE group,the levels of PAG,PAC-1,CD62 P and Scr were significantly higher than those in the no MACE group,and the levels of left ventricular ejection fraction(EF)and PT were significantly lower than those in the no MACE group(P<0.05).ROC curve analysis showed that the areas under the curve of PAG,PAC-1,CD62 P,PT and Scr in predicting MACE were 0.895,0.894,0.806,0.937 and 0.672 respectively.Multivariate Logistic regression analysis showed that age>70 years old,diseased vessels≥3,EF<53%,PAG>43.155%,PAC-1>15.560%,CD62P>15.100%,PT<14.975 s and Scr>83.810μmol/L were the risk factors of MACE(P<0.05).Conclusion High levels of PAG,GP,PAC-1,CD62P and Scr as well as low levels of PT and EF are risk factors for MACE in patients with coronary heart disease after PCI.

关 键 词：血小板聚集试验 血小板膜糖蛋白 实验室指标 冠心病 经皮冠状动脉介入术 主要心血管不良事件 

分 类 号：R541.4[医药卫生—心血管疾病] R714.252[医药卫生—内科学]