老年急性心肌梗死患者血清脂蛋白a、PTX3及PLR与近期预后的关系  

Relationship between serum lipoprotein a,pentraxin 3,platelet-to-lymphocyte ratio and short-term prognosis in elderly patients with acute myocardial infarction

作　　者：李铎 黄祖峰 张璐靓 Li Duo;Huang Zufeng;Zhang Luliang(Department of Clinical Laboratory,the Ninth People's Hospital of Zhengzhou,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州市第九人民医院检验科,河南郑州450000

出　　处：《感染、炎症、修复》2025年第2期116-119,共4页Infection Inflammation Repair

摘　　要：目的:探讨老年急性心肌梗死(AMI)患者血清脂蛋白a、正五聚蛋白3(PTX3)、血小板/淋巴细胞比值(PLR与经皮冠状动脉介入术(PCI)术后近期预后的关系。方法:选取2022年1月至2024年1月于郑州市第九人民医院收治的102例行PCI的老年AMI患者,根据PCI术后3个月内是否发生心力衰竭、再发心肌梗死、恶性心律失常、心绞痛、休克、心源性死亡等主要心血管不良事件分为预后良好组(n=73)和预后不良组(n=29)。比较两组一般资料及术前脂蛋白a、PTX3、PLR水平。采用Logistic回归方法分析影响老年AMI患者PCI术后近期预后的危险因素,用受试者工作特征(ROC)曲线评估预测价值。结果:两组发病距PCI时间、术前心功能Killip分级、白细胞计数比较,差异有统计学意义(P<0.05)。预后良好组术前脂蛋白a、PTX3、PLR水平均低于预后不良组(P<0.05)。Logistic回归分析显示,脂蛋白a(OR=1.697,P=0.015)、PTX3(OR=2.298,P=0.032)、PLR(OR=3.370,P=0.018)均为影响老年AMI患者PCI术后近期预后的独立危险因素。术前脂蛋白a、PTX3、PLR、联合检测预测患者预后的ROC曲线下面积分别为0.643、0.667、0.650、0.911,联合检测曲线下面积最大。结论:脂蛋白a、PTX3、PLR均为影响老年AMI患者PCI术后近期预后的独立危险因素,可预测预后,且联合检测价值更高。Objective:To explore the relationship between serum lipoprotein a,pentraxin3(PTX3),platelet-tolymphocyte ratio(PLR)and short-term prognosis in elderly patients with acute myocardial infarction(AMI).Methods:A total of 102 elderly patients with AMI undergoing percutaneous coronary intervention(PCI)in Ninth People's Hospital of Zhengzhou were enrolled as the research objects from January 2022 to January 2024.They were divided into good prognosis group(73 cases)and poor prognosis group(29 cases)according to the presence or absence of major adverse cardiac events(heart failure,recurrent myocardial infarction,malignant arrhythmia,angina pectoris,shock,cardiac death)within 3 months after PCI.The preoperative levels of lipoprotein a,PTX3 and PLR were compared between the two groups.The influencing factors of short-term prognosis in elderly AMI patients after PCI were analyzed by Logistic regression analysis,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of indicators.Results:There were significant differences in interval from onset to PCI,preoperative Killip grading of cardiac function and white blood cell count between the two groups(P<0.05).The preoperative levels of lipoprotein a,PTX3 and PLR in good prognosis group were lower than those in poor prognosis group(P<0.05).Logistic regression analysis showed that lipoprotein a(OR=1.697,P=0.015),PTX3(OR=2.298,P=0.032)and PLR(OR=3.370,P=0.018)were independent risk factors influencing the shortterm prognosis of elderly AMI patients after PCI(P<0.05).ROC curve analysis showed that area under curve(AUC)values of preoperative lipoprotein a,PTX3,PLR and combined detection for predicting prognosis were 0.643,0.667,0.650 and 0.911,respectively.AUC of combined detection(0.911)was greater than that of single index.Conclusions:The increased lipoprotein a,PTX3 and PLR are independent risk factors of affecting the short-term prognosis of elderly AMI patients after PCI.The three indexes have certain predictive value for short-term prognosis

关 键 词：心肌梗死 急性 脂蛋白A 正五聚蛋白3 血小板/淋巴细胞比值 

分 类 号：R542.22[医药卫生—心血管疾病]