系统免疫炎症指数对冠状动脉支架植入术后的心肌梗死患者并发支架内血栓的预测价值  

Predictive value of systemic immune-inflammation index to stent thrombosis in patients with myocardial infarction after intracoronary stent implantation

作　　者：杨凯 张羽 Yang Kai;Zhang Yu(Department of Cardiovascular Surgery,940th Hospital,Chinese PLA Joint Logistics Support Force,Lanzhou 730050,China;不详)

机构地区：[1]联勤保障部队第九四○医院心血管外科,兰州730050

出　　处：《中国循证心血管医学杂志》2024年第6期690-693,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：甘肃省青年科技基金计划(21JR7RA011)。

摘　　要：目的探讨系统免疫炎症指数对冠状动脉支架植入术后的心肌梗死患者并发支架内血栓的预测价值。方法回顾性收集联勤保障部队第九四○医院于2021年1月至2022年6月收治的因心肌梗死行冠状动脉支架植入术患者462例,对其随访1年,根据患者是否发生支架内血栓,分为支架内血栓组(n=54)和对照组(n=408)。观察两组患者的临床特征,使用ROC曲线分析系统免疫炎症指数对冠状动脉支架植入术后的心肌梗死患者并发支架内血栓的预测价值。结果两组患者年龄、糖尿病、支架数目、药物依从性和系统免疫炎症指数等方面比较,有统计学差异(P<0.05)。系统免疫炎症指数对支架内血栓具有较好的预测价值,曲线下面积为0.786(95%CI:0.725~0.846,P=0.000),最佳诊断界值为653,此时敏感性和特异性分别为0.704和0.686。多因素回归分析显示糖尿病、未规律服药、支架数目≥2和系统免疫炎症指数≥653,是冠状动脉支架植入术后支架内血栓形成的独立危险因素(P<0.05)。与对照组比较,支架内血栓组患者再发心肌梗死发生率显著增高(33.33%vs.13.24%,P=0.000);死亡率显著增高(11.11%vs.2.70%,P=0.002)。结论系统免疫炎症指数对冠状动脉支架植入术后的心肌梗死患者并发支架内血栓具有一定预测价值。Objective To discuss the predictive value of systemic immune-inflammation index(SII)to stent thrombosis in patients with myocardial infarction(MI)after intracoronary stent implantation.Methods MI patients undergone intracoronary stent implantation(n=462)were retrospectively chosen from the 940th Hospital of Chinese PLA Joint Logistics Support Force from Jan.2021 to June 2022.All patients were followed up for 1 y,and divided into stent thrombosis group(n=54)and control group(n=408)according to they had or had not stent thrombosis.The clinical characteristics were observed in 2 groups.The predictive value of SII to stent thrombosis in MI patients after intracoronary stent implantation by using ROC curve analysis.Results The comparison in age,diabetes,stent numbers,drug compliance and SII showed statistical differences between 2 groups(P<0.05).SII had a higher predictive value to stent thrombosis(AUC=0.786,95%CI:0.725~0.846,P=0.000),and the optimal diagnostic critical value was 653,sensitivity was 0.704 and specificity was 0.686.The results of multi-factor regression analysis showed that diabetes,irregular medication,stent numbers≥2 and SII≥653 were independent risk factors of postoperative stent thrombosis(P<0.05).The incidence of relapse MI increased significantly(33.33%vs.13.24%,P=0.000)and mortality increased significantly(11.11%vs.2.70%,P=0.002)in stent thrombosis group compared with control group.Conclusion SII has some predictive value to stent thrombosis in MI patients after intracoronary stent implantation.

关 键 词：冠状动脉支架植入术 系统免疫炎症指数 心肌梗死 支架内血栓 

分 类 号：R542.2[医药卫生—心血管疾病]