血清γ-谷氨酰转移酶/血小板比值与急性STEMI患者心力衰竭发病的关系研究  

The relationship between the ratio of serumγ-glutamyl transferase and platelet count and the incidence of heart failure in patients with acute STEMI

作　　者：杨国爱 陈晓琳 申巧丽 许抗抗 YANG Guoai;CHEN Xiaolin;SHEN Qiaoli;XU Kangkang(Department of Cardiology,Cangzhou People's Hospital,Cangzhou Hebei 061000,China)

机构地区：[1]沧州市人民医院心内科,河北沧州061000

出　　处：《中国急救复苏与灾害医学杂志》2024年第10期1267-1270,1297,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：沧州市重点研发计划指导项目(编号:183302064)。

摘　　要：目的探究血清γ-谷氨酰转移酶与血小板(GGT/PLT)比值和急性STEMI患者心力衰竭发病的关系研究。方法回顾性选取沧州市人民医在2021年1月—2023年1月间收治的ST段急性抬高型心肌梗死(STEMI)患者136例,根据患者经皮冠状动脉介入治疗后心力衰竭情况分为观察组(70例,心力衰竭),参照组(66例,无心力衰竭)。两组患者均采用全自动血细胞分析仪和流式细胞仪检测入院次日PLT,进行血清GGT测定,计算GGT/PLT比值;收集所有患者临床资料并进行比较,多因素分析急性STEMI患者经皮冠状动脉介入治疗后心力衰竭的影响因素,用受试者工作特征(ROC)曲线分析血清GGT/PLT比值对急性STEMI患者经皮冠状动脉介入治疗后心力衰竭的预测价值。结果观察组GGT/PLT比值高于参照组(P<0.05)。两组性别、罪犯血管、右冠状动脉、最大支架直径、置入支架数目、置入支架长度、术后24 h临床资料、左心室收缩末期容积、术后24 h实验室指标、低密度脂蛋白、血尿素氮、血小板计数、甘油三酯、总胆固醇等一般资料比较差异均无统计学意义(P>0.05)。观察组NLR、PLR、血肌酐高于参照组(P<0.05)。经二元Logistic回归分析结果显示,NLR、PLR、血肌酐、GGT/PLT比值均是急性STEMI患者经皮冠状动脉介入治疗后心力衰竭的独立危险因素(P<0.05)。ROC曲线结果显示,GGT/PLT比值预测急性STEMI患者经皮冠状动脉介入治疗后心力衰竭的灵敏度为84.21%,特异度为98.70%,曲线下面积(AUC)为0.891(P<0.05)。结论血清GGT/PLT比值与急性STEMI患者经皮冠状动脉介入治疗后心力衰竭发生风险相关,是发生心力衰竭的独立危险因素,临床通过检测GGT/PLT比值可较好预测患者心力衰竭发生情况。Objective To investigate the relationship between the ratio of serumγ-glutamyl transferase to platelet count(GGT/PLT)and the incidence of heart failure.Methods A total of 136 acute STEMI patients admitted to our hospital from January 2021 to January 2023 were retrospectively selected and divided into observation group(70 cases with heart failure)and reference group(66 cases without heart failure)according to their heart failure status after emergency percutaneous coronary intervention.Automatic blood cell analyzer and flow cytometry were used to detect PLT on the day after admission,serum GGT was measured,GGT/PLT ratio was calculated,clinical data of all patients were collected and compared,and the influencing factors of heart failure after emergency percutaneous coronary intervention in acute STEMI patients were analyzed by multifactorial analysis.The predictive value of serum GGT/PLT ratio after emergency percutaneous coronary intervention in acute STEMI patients was analyzed using receiver operating characteristic(ROC)curve.Results GGT/PLT ratio in observation group was higher than that in reference group(P<0.05).Gender,smoking history,diabetes mellitus,hypertension,hyperlipidemia,age,body mass index,alcohol consumption history,criminal blood vessel,right coronary artery,maximum stent diameter,number of stents implanted,length of stents implanted,clinical data 24 hours after surgery,left ventricular end-systolic volume,24 hours after surgery There were no significant differences in laboratory indexes,low density lipoprotein,blood urea nitrogen,platelet count,triglyceride and total cholesterol(P>0.05).NLR,PLR and serum creatinine in observation group were higher than those in reference group(P<0.05).Binary Logistic regression analysis showed that NLR,PLR,serum creatinine and GGT/PLT ratio were independent risk factors for heart failure after emergency percutaneous coronary intervention in acute STEMI patients(P<0.05).ROC curve results showed that GGT/PLT ratio had 84.21%sensitivity,98.70%specificity and 0.891

关 键 词：急性ST段抬高型心肌梗死 心力衰竭 Γ-谷氨酰转移酶 罪犯血管 

分 类 号：R541.6[医药卫生—心血管疾病]