摘要
目的:探讨血小板-淋巴细胞聚集体(PLy A)水平和血小板/淋巴细胞比值(PLR)在预测急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)术后心肌无复流中的临床价值。方法:共纳入行急诊PCI的STEMI患者93例,PCI术前采集外周静脉血,应用流式细胞仪检测PLy A水平。根据PCI后是否有心肌无复流分为无复流组(n=24)和复流组(n=69)。心肌无复流定义为:在没有解剖性狭窄及血管痉挛的情况下,冠状动脉心肌梗死溶栓治疗临床试验(TIMI)血流分级≤2级。结果:24例(25.8%)STEMI患者急诊PCI术后发生心肌无复流。与复流组相比,无复流组PLy A水平明显升高(P<0.05)。多因素Logistic回归分析表明,PLR是心肌无复流发生的独立危险因素(OR=2.28,95%CI:1.15~3.29,P=0.023)。受试者工作特征(ROC)曲线分析表明,当PLR大于118.4%时,PLR预测急诊PCI术后心肌无复流发生的敏感度为69.2%,特异度为63.2%,曲线下面积为0.715(95%CI:0.521~0.908,P=0.042)。结论:PLR可能是一种预测STEMI患者急诊PCI术心肌无复流发生独立而有效的指标。
Objectives： To investigate the clinical value of platelet-lymphocyte aggregates（PLy A） and platelet lymphocyte ratio（PLR） in predicting myocardial no reflow（MNR） in patients with acute ST elevation myocardial infarction（STEMI） underwent emergency percutaneous coronary intervention（PCI）. Methods： A total of 93 eligible STEMI patients undergoing primary PCI were included in the current study. PLy A level was determined by flow cytometry from peripheral venous blood sample. According to whether there were myocardial reflow after PCI, they were divided into no-reflow group（n=24） and reflow group（n=69）. No-reflow was defined as coronary blood flow grade thrombolysis in myocardial infarction ≤ 2.Results： MNR was observed in twenty-four patients（25.8%）. The level of PLy A was significantly higher in no-reflow group than in reflow group（P〈0.05）. Multiple logistic regression analysis showed that PLR（OR=2.28, 95%CI： 1.15-3.29, P=0.023） was an independent risk factor of MNR. Receiver operating characteristic（ROC） curve analysis revealed that PLR（area under the ROC curve 0.715, 95% CI： 0.521-0.908, P=0.042; optimal threshold118.4%） had a predictive value of MNR with sensitivity of 69.2% and specificity of 63.2%. Conclusions： Our study results indicate that PLR is an independent and effective indicator of predicting MNR in STEMI patients undergoing emergency PCI.
作者
孙静
任法新
孙晓健
张传焕
李留东
董梅
SUN Jing;REN Fa-xin;SUN Xiao-jian;ZHANG Chuan-huan;LI Liu-dong;DONG Mei(Department of Cardiology,Yantai Yuhuangding Hospital Affiliated to Qingdao University,Yantai（264000）,Shandong,China)
出处
《中国循环杂志》
CSCD
北大核心
2018年第9期869-872,共4页
Chinese Circulation Journal
基金
国家自然科学基金青年基金(81500271)
山东省自然科学基金联合专项(ZR2015HL004)
烟台市科技发展计划(2015WS031)
