| 李世添,陈宇明,韦吉伟.血小板 /淋巴细胞比值、中性粒细胞 /淋巴细胞比值及危险分层评分对 ST段抬高型心肌梗死行经皮冠状动脉介入术后主要心血管不良事件的预测价值[J].安徽医药,2023,27(2):328-332. |
| 血小板 /淋巴细胞比值、中性粒细胞 /淋巴细胞比值及危险分层评分对 ST段抬高型心肌梗死行经皮冠状动脉介入术后主要心血管不良事件的预测价值 |
| Predictive value of PLR, NLR and risk stratification score for major cardiovascular adverse events in patients with ST segment elevation myocardial infarction after direct percutaneous coronary intervention |
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| DOI：10.3969/j.issn.1009-6469.2023.02.026 |
| 中文关键词: ST段抬高型心肌梗死 血小板 /淋巴细胞比值 中性粒细胞 /淋巴细胞比值 GRACE评分 主要心血管不良事件 预测价值 |
| 英文关键词: ST elevation myocardial infarction Platelet/Lymphocyte ratio Neutrophil/Lymphocyte ratio GRACE score Ma-jor adverse cardiac events Predictive value |
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| 中文摘要: |
| 目的探讨血小板 /淋巴细胞比值( PLR)、中性粒细胞 /淋巴细胞比值( NLR)及危险分层评分对 ST段抬高型心肌梗死(STEMI)病人行直接经皮冠状动脉介入术( PCI)治疗后主要心血管不良事件( MACE)的预测价值。方法选取 2018年 1月至 2019年 12月在南宁市第六人民医院行直接 PCI治疗的 STEMI病人 135例，根据术后 30 d内是否发生 MACE分为 MACE组( n= 42)和非 MACE组( n=93)。所有病人入院确诊后均行直接 PCI治疗，在术后 7d进行血常规检查，根据检测计算 PLR、NLR。采用全球急性冠状动脉事件注册( GRACE)危险分层评分对病人进行风险评分。比较 MACE组和非 MACE组病人 PLR、NLR、 GRACE评分，并观察不同水平 PLR、NLR、GRACE评分的病人术后 30 d内 MACE的发生率。以受试者操作特征( ROC)曲线下面积(AUC)评估 PLR、NLR、GRACE评分及三者联合对 STEMI病人术后 MACE的预测价值。结果 MACE组病人 PLR［(128.4±13.6)分比( 112.2±21.6)分］、 NLR［( 5.74±1.42)分比( 5.12±1.13)分］、 GRACE评分［( 138.0±15.0)分比( 106.0±24.0)分］均高于非 MACE组，差异有统计学意义( P<0.05)。高 PLR的 STEMI病人术后 30 d内 MACE发生率高于低 PLR的病人( P<0.05)。高 NLR的 STEMI病人术后 30 d内 MACE的发生率高于低 NLR病人( P<0.05)。 GRACE评分越高， STEMI病人术后 30 d内 MACE发生率越高，差异有统计学意义( P<0.05)。 PLR、NLR、GRACE评分及三者联合预测 STEMI病人 PCI术后 30 d MACE的 AUC分别为 0.74、0.75、0.79、0.86(P<0.05)。分析结果显示，三者联合的 AUC均显著大于 PLR、NLR、GRACE评分( P<0.05)。结论 STEMI病人行直接 PCI治疗后进行 PLR、NLR及 GRACE评分检测有利于预测病人术后 30 d内 MACE的发生风险，且三者联合的预测价值更高。 |
| 英文摘要: |
| Objective To explore the predictive value of platelet/lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR) andrisk stratification score for major cardiovascular adverse events in patients with ST segment elevation myocardial infarction after directpercutaneous coronary intervention (PCI). Methods A total of 135 STEMI patients who underwent direct PCI in Nanning Sixth People'sHospital from January 2018 to December 2019 were selected.According to whether MACE occurred within 30 days after operation, pa-tients were divided into MACE group (n=42) and non-MACE group (n=93). All patients were treated with direct PCI after admission,and blood routine examination was performed 7 days after operation. PLR and NLR were calculated according to the test results. Theglobal register of acute coronary events (GRACE) risk stratification score was used to assess the risk of patients. The PLR, NLR and GRACE scores of patients in MACE group and non-MACE group were compared, and the incidence of MACE within 30 days after oper-ation was compared in patients with different levels of PLR, NLR and GRACE scores.The area under curve (AUC) of receiver operatingcharacteristic (ROC) curve was used to evaluate the predictive value of PLR, NLR, GRACE scores and the combination of the three forMACE in patients with STEMI. Results PLR [(128.4±13.6) score vs. (112.2±21.6) score], NLR [(5.74±1.42) score vs. (5.12±1.13) score] and GRACE scores [(138.0±15.0) score vs. (106.0±24.0) score] in MACE group were higher than those in non-MACE group (P< 0.05). The incidence of MACE in STEMI patients with high PLR was higher than that in patients with low PLR(P<0.05). The incidence of MACE in STEMI patients with high NLR was higher than that in patients with low NLR (P<0.05). The higher the score of GRACE,the higher the incidence of MACE within 30 days after operation, the difference was statistically significant (P<0.05). The AUC of PLR,NLR, GRACE scores and the combination of them for predicting MACE of patients after operation were 0.74, 0.75, 0.79 and 0.86, re-spectively (P<0.05).The analysis showed that the AUC of the combination of the three was significantly higher than that of PLR, NLRand GRACE scores (P<0.05).Conclusion PLR, NLR and GRACE scores of STEMI patients after PCI are helpful to predict the risk ofMACE within 30 days, and the combined application of the three has a higher predictive value. |
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