PER、Ang2、PFR及NLR水平在急性前壁心肌梗死患者术后LVSD中的预测效能  

Predictive efficacy of PER,Ang2,PFR and NLR in postoperative LVSD in patients with acute anterior myocardial infarction

作　　者：韩婷婷 张丽娜[1] 李辉[1] 杨志家[1] Han Tingting;Zhang Lina;Li Hui;Yang Zhijia(the Third Department of Internal Medicine-Cardiovascular,Handan Central Hospital of Hebei Province,Handan Hebei 056003,China)

机构地区：[1]河北省邯郸市中心医院心内三科,河北邯郸056003

出　　处：《遵义医科大学学报》2023年第2期173-176,181,共5页Journal of Zunyi Medical University

基　　金：河北省医学科学研究基金资助项目(NO:20210854)。

摘　　要：目的 探讨高峰射血率(PER)、高峰充盈率(PFR)、促血管生成素2(Ang2)及中性粒细胞/淋巴细胞比值(NLR)对急性前壁心肌梗死(AAMI)术后左心室收缩功能不全(LVSD)的预测效能。方法 回顾性分析2021年6-12月期间在本院心内科接受急诊经皮冠状动脉介入术的166例AAMI患者,所有患者均应用QPS软件分析心肌灌注图像分析左心室功能,包括LVEF、舒张末期容积(EDV)、收缩末期容积(ESV)、PER及PFR,应用酶联免疫法检测所有患者血清中Ang2值,采用全自动血液细胞分析仪检测及中性粒细胞、淋巴细胞计数并计算NLR值。观察AAMI患者左心室收缩功能情况并根据是否发生LVSD建立分组,对比两组PER、PFR、Ang2及NLR指标水平,采用ROC曲线分析PER、PFR、Ang2、NLR单项及联合检测对AAMI患者术后LVSD的预测效能。结果 所有患者经Simpson检测后,发生LVSD的患者共62例(占比37.35%),纳入LVSD患者组;未发生LVSD的患者共104例(占比62.65%),纳入非LVSD患者组;两组患者EDV、ESV、PER、PFR水平对比均具有显著统计学差异(P均<0.001);LVSD患者组Ang2、NLR指标水平均明显高于非LVSD患者组(P<0.05);采用ROC曲线分析显示4项指标联合检测效能明显高于单一指标检测(AUC=0.925)。结论 AAMI患者行急诊经皮冠状动脉介入术后采用PER、PFR、Ang2及NLR联合检测对患者是否发生LVSD具有较高的预测效能,后续临床可监测患者上述4项指标并采取针对性诊疗方案来改善患者预后。Objective To investigate the predictive efficacy of peak ejection rate(PER), peak filling rate(PFR), angiopoietin-2(Ang2) and neutrophil/lymphocyte ratio(NLR) for left ventricular systolic dysfunction(LVSD) after acute anterior myocardial infarction(AAMI).Methods A total of 166 patients with AAMI who underwent emergency percutaneous coronary intervention in the Department of Cardiology of our hospital from June to December 2021 were retrospectively analyzed.QPS software was used to analyze myocardial perfusion images of all patients to analyze left ventricular function, including LVEF, end-diastolic volume(EDV), end-systolic volume(ESV), PER and PFR.Serum Ang2 was detected by enzyme-linked immunosorbent assay, and neutrophils and lymphocytes were counted and NLR was calculated by automatic blood cell analyzer.The levels of PER, PFR, Ang2 and NLR were compared between the two groups.ROC curve was used to analyze the predictive efficacy of PER, PFR, Ang2 and NLR alone and in combination for LVSD in AAMI patients.Results After Simpson test, 62 patients(37.35%) with LVSD were included in the LVSD group.A total of 104 patients without LVSD(62.65%) were included in the non-LVSD group.There were significant differences in EDV, ESV, PER and PFR levels between the two groups(all P<0.001).The levels of Ang2 and NLR in LVSD group increased significantly than those in non-LVSD group(P<0.05).ROC curve analysis showed that the detection efficiency of four indexes combined increased significantly than that of single index(AUC=0.925).Conclusion The combined detection of PER, PFR, Ang2 and NLR in AAMI patients after emergency percutaneous coronary intervention has a high predictive efficiency for LVSD.The above four indicators can be monitored in subsequent clinical practice and targeted diagnosis and treatment can be adopted to improve the prognosis of patients.

关 键 词：急性前壁心肌梗死 高峰射血率 高峰充盈率 促血管生成素2 中性粒细胞/淋巴细胞比值 左心室收缩功能不全 预测效能 

分 类 号：R542.22[医药卫生—心血管疾病]