Influencing factors of short-term prognosis in patients with acute ST segment elevation myocardial infarction
-
摘要: 目的 探讨中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)及心脏超声相关参数在评价急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入术(PCI)后近期预后中的价值。 方法 选取在本院行PCI治疗的200例STEMI患者,按照主要不良心血管事件(MACE)发生情况分为非MACE组(n=143)和MACE组(n=57)。比较2组术后1、3、5 d的NLR、PLR水平。比较2组术后3 d的心脏超声相关参数［左室壁厚度(LVPW), 左房容积(LAV), 心输出量(CO), 左室射血分数(LVEF), 二尖瓣口舒张早期最大血流速度(E), E峰血流减速时间(DT), 室壁运动指数(WMSI)］。采用COX回归模型分析STEMI患者PCI后再发MACE的相关影响因素。 结果 MACE组术后1、3、5 d的NLR、PLR水平均高于非MACE组,差异有统计学意义(P<0.05)。MACE组术后3 d的LVPW、E、WMSI高于非MACE组,LAV、CO、LVEF、DT低于非MACE组,差异均有统计学意义(P<0.05)。多因素COX回归分析显示, NLR、PLR及各心脏超声参数与STEMI患者PCI后MACE发生风险具有相关性(P<0.05)。结论 NLR、PLR及心脏超声相关参数与STEMI患者PCI后近期MACE发生风险增高具有相关性,能够较好地预测MACE的发生,对改善患者近期预后具有积极的意义。
-
关键词:
- 急性ST段抬高型心肌梗死 /
- 中性粒细胞与淋巴细胞比值 /
- 血小板与淋巴细胞比值 /
- 经皮冠状动脉介入术 /
- 主要不良心血管事件
Abstract: Objective To explore the value of neutrophil to lymphocyte ratio(NLR), platelet to lymphocyte ratio(PLR)and echocardiography related parameters in evaluating the short-term prognosis of patients with acute ST segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI). Methods Totally 200 STEMI patients with PCI were selected. According to the occurrence of major adverse cardiovascular events(MACE), the patients were divided into non-MACE group(n=143)and MACE group(n=57). The levels of NLR and PLR were compared between the two groups at 1 day, 3 and 5 days after operation. Echocardiographic parameters［left ventricular wall thickness(LVPW), left atrial volume(LAV), cardiac output(CO), left ventricular ejection fraction(LVEF), maximum flow velocity of mitral orifice in early diastolic phase(E), deceleration time of E peak blood flow(DT)and wall motion score index(WMSI)］were compared between the two groups at 3 days after operation. COX regression model was used to analyze the related factors of recurrence of MACE in STEMI patients after PCI. Results The levels of NLR and PLR in the MACE group were significantly higher than those in the non-MACE group at 1 day, 3 and 5 days after operation(P<0.05). At 3 days after operation, the LVPW, E and WMSI of the MACE group were significantly higher than those of the non-MACE group, while the LAV, CO, LVEF and DT were significantly lower than those of the non-MACE group(P<0.05). Multivariate COX regression analysis showed that NLR, PLR and echocardiographic parameters were correlated with risk of MACE in STEMI patients after PCI(P<0.05). Conclusion NLR, PLR and echocardiographic parameters - are correlated with the increased risk of MACE in STEMI patients after PCI, which can better predict the occurrence of MACE and have a positive significance for improving the short-term prognosis of STEMI patients. -
-
李庆军, 柯子奋, 梁妍, 等. 中性粒细胞与淋巴细胞比值及淋巴细胞与单核细胞比值与急性ST段抬高型心肌梗死患者经皮冠状动脉介入治疗后左心室重构的关系研究[J]. 实用心脑肺血管病杂志, 2020, 28(7): 29-36. 梁建光, 刘家超, 戴冬霞, 等. 中性粒细胞/淋巴细胞比值对老年急性ST段抬高型心肌梗死合并急性心力衰竭患者的诊断价值研究[J]. 中国实用医药, 2020, 15(18): 40-42. KRASNIQI X, BERISHA B, GASHI M, et al. Influence of apelin-12 on troponin levels and the rate of MACE in STEMI patients[J]. BMC Cardiovasc Disord, 2017, 17(1): 195-201.
陈桂坚, 彭志坚, 黄华. ST段抬高型心肌梗死患者经皮冠状动脉介入治疗后高校正心肌梗死溶栓治疗试验帧数临床预测模型[J]. 中国介入心脏病学杂志, 2020, 28(5): 264-269. 任浩进, 王丽岳, 黄莉芳. 炎性标志物与ST段抬高型心肌梗死患者经皮冠状动脉介入治疗后心肌梗死面积的相关性及预测模型的构建研究[J]. 实用心脑肺血管病杂志, 2020, 28(3): 34-39. 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 急性ST段抬高型心肌梗死诊断和治疗指南(2019)[J]. 中华心血管病杂志, 2019, 47(10): 766-783. 陈鑫森, 黄钟, 李桂花. 中性粒细胞/淋巴细胞比值联合平均血小板体积对急性STEMI患者PCI术后发生院内主要不良心血管事件的预测价值[J]. 中国全科医学, 2020, 23(9): 1117-1126. ZORLU C, KOSEOGLU C. Comparison of the Relationship Between Inflammatory Markers and Contrast-Induced Nephropathy in Patients With Acute Coronary Syndrome After Coronary Angiography[J]. Angiology, 2020, 71(3): 249-255.
刘勇, 姜东伟. ST段抬高型心肌梗死患者PLR和NLR与梗死相关冠状动脉血流通畅状况的关系[J]. 实验与检验医学, 2019, 37(5): 885-888. 邹华丽. 24 h动态心电图联合NLR值预测急性心肌梗死后恶性心律失常的临床价值[J]. 河北医学, 2019, 25(4): 598-602. 范婧尧, 王晓, 周生辉, 等. 中性粒细胞淋巴细胞比值与急性ST段抬高型心肌梗死患者冠状动脉病变严重程度的关联研究[J]. 中国心血管病研究, 2018, 16(2): 123-126. 伊尔夏提·吐逊江, 哈斯达尔·米地里别克, 何鹏义, 等. 血小板与淋巴细胞比值对新疆STEMI患者直接PCI术后无复流及短期预后的预测价值[J]. 临床心血管病杂志, 2020, 36(4): 341-346. 徐健, 赵世杰, 牛一蒙, 等. 血小板淋巴细胞比值与老年急性冠状动脉综合征患者冠状动脉介入治疗围术期心肌梗死的相关分析及其预测价值[J]. 中国医科大学学报, 2019, 48(8): 719-725. VAKILI H, SHIRAZI M, CHARKHKAR M, et al. Correlation of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio with thrombolysis in myocardial infarction frame count in ST-segment elevation myocardial infarction[J]. Eur J Clin Invest, 2017, 47(4): 322-327.
陆志锋, 陈晞明, 王世祥. PDW和PLR对急性SETMI患者PPCI后心肌微循环障碍的预测价值[J]. 重庆医学, 2019, 48(8): 1367-1369. 吴彩凤, 徐日新, 张强, 等. 微循环阻力指数评估急性前壁ST段抬高型心肌梗死患者急诊冠状动脉介入治疗预后的价值及相关影响因素[J]. 实用临床医药杂志, 2019, 23(16): 65-69 , 75.
周莹峰. 阿托伐他汀对急性ST段抬高型心肌梗死患者急诊经皮冠状动脉介入治疗术后无复流现象的作用[J]. 实用临床医药杂志, 2019, 23(2): 40-43. PASHAPOUR P, GHAFFARII S, SEPARHAM A. The relationship of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in peripheral blood with ST-segment resolution and the clinical outcomes of STEMI patients receiving thrombolytic therapy[J]. Rom J Intern Med, 2019, 57(1): 47-54.
-
期刊类型引用(2)
1. 赖奇琨，文强，冷周江才，付曦文，唐明虎. 基于STC单片机糖尿病足压力缓解装置的设计. 黑龙江科学. 2025(06): 52-56 . 
百度学术
2. 李钰，林玲霞，苏媛媛，袁刚. 新型压力监测设备在导尿患者膀胱锻炼的应用. 医学研究杂志. 2021(01): 119-123 . 百度学术
其他类型引用(1)
计量
- 文章访问数: 421
- HTML全文浏览量: 113
- PDF下载量: 11
- 被引次数: 3
下载:
苏公网安备 32100302010246号