WMR与NLR对STEMI患者PCI术后近期MACE发生的预测价值  

Predictive Value of WMR and NLR for Early MACE Occurrence in STEMI Patients After PCI

作　　者：何献春 贾国力 刘英炜 李晓威 HE Xianchun;JIA Guoli;LIU Yingwei;LI Xiaowei(Department of Cardiology,Zhoukou Central Hospital,Zhoukou Henan 466000,China)

机构地区：[1]周口市中心医院心血管内科,河南周口466000

出　　处：《临床研究》2025年第5期1-5,共5页Clinical Research

摘　　要：目的探讨白细胞计数/平均血小板体积比值(WMR)与中性粒细胞/淋巴细胞比值(NLR)在ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入术(PCI)后近期主要不良心血管事件(MACE)中的预测价值。方法选取2019年2月至2022年2月于周口市中心医院接受PCI治疗的60例STEMI患者,依据术后30 d是否发生MACE分为MACE组(n=17)与非MACE组(n=43)。比较两组患者临床及实验室指标,分析影响因素,采用受试者工作特征(ROC)曲线评估WMR、NLR单独及联合检测预测MACE的价值。结果MACE组Killip分级Ⅱ~Ⅳ级(76.47%)人数占比多于非MACE组(32.56%),差异有统计学意义(P<0.05);MACE组的WMR、NLR、高敏C反应蛋白(hs-CRP)和肌酸激酶同工酶(CKMB)峰值高于非MACE组,差异有统计学意义(P<0.05);Logistic回归分析显示,Killip分级越高、WMR升高、NLR升高、hs-CRP升高和CKMB峰值升高均会增加患者术后近期发生MACE的风险;WMR、NLR及WMR联合NLR预测患者PCI术后近期MACE发生的曲线下面积(AUC)值分别为0.766、0.816和0.888,预测价值较高。结论WMR与NLR水平均为PCI术后STEMI患者发生MACE的影响因素,联合预测效果优于单项指标,可作为临床风险评估的重要参考。Objective To explore the predictive value of the white blood cell count/mean platelet volume ratio(WMR)and the neutrophil/lymphocyte ratio(NLR)for early major adverse cardiovascular events(MACE)following percutaneous coronary intervention(PCI)in patients with ST-segment elevation myocardial infarction(STEMI).Methods A total of 60 STEMI patients who underwent PCI at Zhoukou Central Hospital from February 2019 to February 2022 were selected.According to whether they experienced MACE within 30 days post-operation,they were divided into a MACE group(n=17)and a non-MACE group(n=43).Clinical and laboratory indicators were compared between the two groups to analyze influencing factors,and receiver operating characteristic(ROC)curves were used to evaluate the predictive value of WMR,NLR,and their combined detection for MACE.Results The proportion of patients in Killip classⅡ-Ⅳin the MACE group(76.47%)was significantly higher than in the non-MACE group(32.56%)(P<0.05).The WMR,NLR,high-sensitivity C-reactive protein(hs-CRP),and peak creatine kinase MB(CKMB)levels in the MACE group were all significantly higher than those in the non-MACE group(P<0.05).Logistic regression analysis revealed that higher Killip class,elevated WMR,NLR,hs-CRP,and peak CKMB levels all increased the risk of early MACE after surgery.The area under the curve(AUC)values for predicting early MACE after PCI using WMR,NLR,and their combination were 0.766,0.816,and 0.888,respectively,indicating high predictive value.Conclusion Both WMR and NLR are significant factors influencing the occurrence of MACE in STEMI patients after PCI.The combined predictive effect is superior to that of single indicators,making it an important reference for clinical risk assessment.

关 键 词：白细胞计数/平均血小板体积比值 中性粒细胞/淋巴细胞比值 ST段抬高型心肌梗死 经皮冠状动脉介入术 主要不良心血管事件 

分 类 号：R542.22[医药卫生—心血管疾病]