冠心病患者冠状动脉介入术前血小板体积分布宽度与预后的相关性研究  

Correlation between platelet volume distribution width and prognosis in patients with coronary heart disease before percutaneous coronary intervention

作　　者：杨彦朝 杨士伟[1] 葛海龙[1] YANG Yanzhao;YANG Shiwei;GE Hailong(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart Lung and Blood Vassel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心内科,100029 [2]北京房山区第一医院心内科

出　　处：《心肺血管病杂志》2024年第12期1233-1238,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家重点研发计划“主动健康和人口老龄化科技应对”重点专项(2022YFC3602500)。

摘　　要：目的:探讨冠心病患者介入术前血小板体积分布宽度(platelet distribution width,PDW)与预后的相关性。方法:采用回顾性研究的方法,收集2014年10月至2020年10月期间在首都医科大学附属北京安贞医院住院治疗的PCI患者13090例,所有患者均于我院术前完善静脉血常规检测,该项检测中包括PDW。将上述所有PCI患者基于PDW数值四等分分组,第一组(PDW≤11.6%)3286例,第二组(11.6%<PDW≤13.3%)3281例,第三组(13.3%<PDW≤17.4%)3280例,第四组(PDW>17.4%)3243例。收集患者资料并进行随访,记录主要的心脑血管不良事件(major adverse cardiovascular and cerebrovascular events,MACCE)及死亡。采用多因素矫正混杂因素的Cox回归分析,研究术前PDW对PCI患者预后的影响。结果:不同PDW组间年龄、陈旧性心肌梗死、心房颤动等,差异均有统计学意义(P<0.05),不同PDW组间MACCE比较,差异有统计学意义(P<0.05)。校正混杂因素后Cox回归分析显示,术前PDW与PCI术后发生缺血性卒中、不稳定性心绞痛、急性ST段抬高性心肌梗死、急性非ST段抬高性心肌梗死及随访死亡均呈正相关,是患者预后的危险因素(HR均>1,P均<0.05)。结论:术前PDW是PCI患者术后独立的危险因素,可以作为未来预测PCI患者预后的指标。Objective:To investigate the correlation between preoperative platelet distribution width and prognosis in patients with coronary artery disease undergoing PCI.Methods:A retrospective study was conducted,including 13090 PCI patients admitted to Beijing Anzhen Hospital,Capital Medical University,from October 2014 to October 2020.All patients underwent preoperative venous blood routine testing,including PDW measurement.Patients were divided into four groups based on PDW values:Group 1(PDW≤11.6%,n=3286),Group 2(11.6%<PDW≤13.3%,n=3281),Group 3(13.3%<PDW≤17.4%,n=3280),and Group 4(PDW>17.4%,n=3243).Patient data were collected,and follow-up was conducted to record major adverse cardiovascular and cerebrovascular events(MACCE)and mortality.Multifactorial Cox regression analysis was performed to study the impact of PDW on the prognosis of PCI patients.Results:The differences observed in age,old myocardial infarction,atrial fibrillation and other factors of different PDW groups showed statistical significance(P<0.05).There were significant differences in MACCE and death among different PDW groups.Cox regression analysis after confounding factors were adjusted showed that preoperative PDW was positively correlated with ischemic stroke,unstable angina pectoris,acute ST elevation myocardial infarction,acute non-ST elevation myocardial infarction and follow-up death after PCI operation,indicating it as a risk factor for patient prognosis(HR>1,P<0.05).Conclusion:Preoperative PDW is an independent risk factor for adverse outcomes in PCI patients and can serve as a predictor for PCI prognosis in the future.

关 键 词：冠心病 经皮冠状动脉介入治疗 血小板体积分布宽度 血小板活化 预后 

分 类 号：R54[医药卫生—心血管疾病]