摘要
目的：探讨ST段抬高型心肌梗死（STEMI）患者血小板计数/淋巴细胞比值（PLR）与冠状动脉病变程度及短期预后的相关性。方法：选择2008-01至2013—12在我院行急诊经皮冠状动脉介入治疗的649例STEMI患者，进行冠状动脉病变的SYNTAX积分评价，将患者分为严重冠状动脉病变组（SYNTAX积分〉22）231例，非严重冠状动脉病变组（SYNTAX积分≤22）418例。另外按照PLR三分位又将649例患者分为高PLR组（PLR≥207）216例，中PLR组（207〉PLR〉94）215例，低PLR组（PLR≤94）218例。分析PLR水平与SYNTAX积分的相关性，及30天全因死亡与PLR的相关性。结果：严重冠状动脉病变组PLR高于非严重冠状动脉病变组（P〈0．001）；SYNTAX积分与PLR存在正相关性（r=0．34，P〈0．001）；PLR是严重冠状动脉病变的独立危险因素（比值比=1．338，95％可信区间：1．028～2．026，P〈0．001]；多因素Cox回归分析显示PLR是STEMI患者发生30天全因死亡的独立预测因素（风险比=1．245，9.5％可信区间：1．153～1．825，P〈0．001）；Kaplan～Meier生仔曲线显示随着PLR水平升高，患者的累积生存率明显降低（P=0．019）。结论：STEMI患者PLR与冠状动脉病变程度相关，并且对患者预后有一定预测价值。
Objective： To assess the relationship between platelet/lymphocyte Ratio （PLR） and the severity of coronary lesion with the short term outcome in patients of ST-Segment elevation myocardial infarction （STEMI）.
Methods： A total of 649 STEMI patients who received PCI in our hospital from 2008-01 to 2013-12 were recruited. According to SYNTAX score, the patients were divided into 2 groups： Severe coronary lesion group, the patients with SYNTAX score〉22, n=231 and Moderate coronary lesion group, the patients with SYNTAX score≤22, n=418. Based on tierce of PLR, the patients were further divided into 3 groups： High PLR group, the patients with PLR≥207, n=216, Medium PLR group, the patients with 207〉PLR〉94, n=215 and Low PLR group, the patients with PLR≤94, n=218. The relationship between PLR and SYNTAX score, the relationship between 30 days all cause death and PLR were analyzed.
Results： The PLR in Severe coronary lesion group was higher than Moderate coronary lesion group, P〈0.001; SYNTAX score was positively related to PLR （r=0.34, P〈0.001）; PLR value was the independent risk factor for severe coronary lesion （OR=1.338, 95% CI 1.028-2.026, P〈0.001）. Multivariate Cox regression analysis showed that PLR was the independent predictor for 30 days all cause mortality in STEMI patients （HR= 1.245, 95% CI 1.153-1.825, P〈0.001）; Kaplan-Meier survival curve presented that with the elevation of PLR, the survival rate in STEMI patients decreased accordingly, P=0.019.
Conclusion： PLR is related to the severity of coronary lesion and it has certain predictive value for short term prognosis in STEMI patients.
出处
《中国循环杂志》
CSCD
北大核心
2015年第3期230-234,共5页
Chinese Circulation Journal
基金
国家自然科学基金(81060025)
新疆维吾尔自治区科技厅高技术研究发展计划(201417102)
