MHR、PLR、脑钠肽及心肌梗死溶栓危险评分对急性心肌梗死新发房颤的预测价值  

Predictive Value of MHR,PLR,BNP and Myocardial Infarction Thrombolytic Risk Score for New Onset Atrial Fibrillation in Acute Myocardial Infarction

作　　者：蔡东东 王志荣 CAI Dongdong;WANG Zhirong(School of First Clinical Medicine,Xuzhou Medical University,Xuzhou 221004,China;Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,China)

机构地区：[1]徐州医科大学第一临床医学院,江苏徐州221004 [2]徐州医科大学附属医院,江苏徐州221006

出　　处：《北华大学学报（自然科学版）》2023年第4期477-481,共5页Journal of Beihua University（Natural Science）

基　　金：江苏省科技厅社会发展基金项目(KS96-037).

摘　　要：目的探讨单核细胞与高密度脂蛋白比值(MHR)、血小板与淋巴细胞比值(PLR)、脑钠肽及心肌梗死溶栓危险评分对急性心肌梗死新发房颤的预测价值.方法选取急性心肌梗死患者144例,根据是否新发房颤分为房颤组(急性心肌梗死新发房颤29例)、对照组(急性心肌梗死115例).收集患者的人口学特征,合并糖尿病、高血压情况,冠脉支架植入术(PCI)情况,入院时心率,服用血管紧张素转换酶抑制剂(ACEI)/血管紧张素受体脑啡肽酶抑制剂(ARNI)情况,服用β受体阻滞剂情况.入院48 h内行心脏彩超检查,记录左心室射血分数及左心房内径.采集患者空腹肘静脉血5 mL,检测血小板、淋巴细胞、单核细胞计数、高密度脂蛋白、脑钠肽水平,计算MHR、PLR,进行心肌梗死溶栓危险评分.结果本研究纳入的144例急性心肌梗死患者中新发房颤29例(20.14%),房颤组患者中男性比例、吸烟史比例、左心室射血分数明显低于对照组,年龄、入院时心率、左心房内径明显高于对照组(P<0.05).房颤组患者高密度脂蛋白水平低于对照组,MHR水平明显高于对照组(P<0.01).房颤组患者血小板计数、PLR水平明显高于对照组(P<0.01).房颤组患者脑钠肽水平、心肌梗死溶栓危险评分明显高于对照组(P<0.01).多因素Logistic回归分析显示,患者入院时心率、MHR、PLR、脑钠肽水平、心肌梗死溶栓危险评分是急性心肌梗死新发房颤的独立影响因素.ROC曲线分析显示,MHR、PLR、脑钠肽水平、心肌梗死溶栓危险评分单独和联合检测对急性心肌梗死新发房颤均具有较高的预测价值(P<0.05),其中联合检测的预测价值最高(AUC=0.942),特异度和阳性预测值明显高于各指标单独检测.结论急性心肌梗死新发房颤患者MHR、PLR、脑钠肽水平及心肌梗死溶栓危险评分高表达,联合检测对急性心肌梗死患者新发房颤具有较高的预测价值.Objective To explore the predictive value of monocyte to high density lipoprotein ratio(MHR),platelet to lymphocyte ratio(PLR),BNP and myocardial infarction thrombolytic risk score(MI)for the new onset of atrial fibrillation in acute myocardial infarction.Method 144 patients with acute myocardial infarction were divided into two groups according to whether new atrial fibrillation occurred:29 patients in the atrial fibrillation group(new atrial fibrillation in acute myocardial infarction)and 115 patients in the control group(acute myocardial infarction).Collect the demographic characteristics of patients,diabetes,hypertension,coronary stent implantation(PCI),heart rate at admission,angiotensin converting enzyme inhibitor(ACEI)/angiotensin receptor enkephalase inhibitor(ARNI)administrationβreceptor blockers.Cardiac color Doppler ultrasound was performed within 48 hours after admission,and left ventricular ejection fraction and left atrial diameter were recorded.Collect 5 mL of fasting elbow vein blood,measure platelet count,lymphocyte count,monocyte count,high-density lipoprotein,BNP,calculate MHR,PLR,and perform thrombolytic risk score of myocardial infarction.Results Among 144 patients with acute myocardial infarction included in this study,29 cases(20.14%)had new onset of atrial fibrillation.The proportion of men,smoking history and left ventricular ejection fraction in patients with atrial fibrillation were significantly lower than those in the control group,and the age,heart rate at admission and left atrium diameter were significantly higher than those in the control group(P<0.05).The levels of high-density lipoprotein and MHR in patients with atrial fibrillation were significantly higher than those in the control group(P<0.01).The platelet count and PLR level in patients with atrial fibrillation were significantly higher than those in the control group(P<0.01).BNP and thrombolytic risk score of myocardial infarction in patients with atrial fibrillation were significantly higher than those in the control gro

关 键 词：急性心肌梗死 房颤 单核细胞/高密度脂蛋白 血小板/淋巴细胞 脑钠肽 心肌梗死溶栓危险评分 

分 类 号：R542[医药卫生—心血管疾病]