摘要
目的探讨急性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)术前中性粒细胞与淋巴细胞比率(NLR)和心肌梗死溶栓(TIMI)风险评分的关系。方法选择390例症状出现12 h内接受PCI治疗的STEMI患者作为研究对象,入院时分别记录TIMI风险评分和NLR。以Spearman检验对STEMI的TIMI风险评分与NLR的相关性进行分析。采用受试者操作特征曲线(ROC)分析NLR、TIMI评分及其组合预测主要心血管事件(MACE)和血管造影无复流发生的价值。结果与TIMI低风险组相比,TIMI高风险组入院时NLR增加。Spearman相关分析显示NLR和TIMI评分相关(P<0.01)。在多变量分析中,TIMI是住院MACE的独立预测因子(RR=1.01,95%CI=1.00~1.06,P<0.05),并且TIMI和NLR均为无复流的独立预测因子(RR=1.02,95%CI=1.00~1.04,P<0.05;RR=1.34,95%CI=1.04~1.73,P<0.05)。ROC分析显示,TIMI评分与NLR组合对短期MACE和无复流的预测效果优于单独应用TIMI评分或NLR。结论NLR与TIMI评分联合应用对STEMI患者PCI术后住院期间MACE和无复流有显著的预测价值。
Objective To investigate the relationship between neutrophils to lymphocytes ratio(NLR)and thrombolysis in myocardial infarction(TIMI)risk score in patients with ST-elevation acute myocardial infarction(STEMI)before percutaneous coronary intervention(PCI).Methods 390 STEMI patients who received PCI within 12 h after the occurrence of symptom were selected as study objects.Their TIMI risk score and NLR levels were separately recorded at the time of admission.Spearman rank correlation was used to analyze the relevance of TIMI risk score and NLR in STEMI patients.A receiver operating characteristic curve(ROC)was used to analyze the value of TIMI risk score,NLR and their combination in predicting MACE and angiographic no-reflow occurrence.Results Compared with the Low-Risk TIMI Group,the High-Risk TIMI Group had the NLR increased at admission.Spearman correlation analysis showed a significant correlation between NLR and TIMI score(P<0.01).In multivariate analysis,TIMI was an independent predictor of hospitalization MACE(RR=1.01,95%CI=1.00‒1.06,P<0.05),and TIMI and NLR were all independent predictors of no reflow(RR=1.02,95%CI=1.00‒1.04,P<0.05;RR=1.34,95%CI=1.04‒1.73,P<0.05).ROC analysis showed that the combination of TIMI score with NLR was superior to single TIMI score or NLR in predicting short-term MACE and no-reflow.Conclusion The combination of NLR and TIMI score has significant value in predicting short-term MACE and non-reflow after PCI in patients with STEMI.
作者
刘富湘
莫介超
陈注有
陈文广
LIU Fu-xiang;MO Jie-chao;CHEN Zhu-you;CHEN Wen-guang(Department of Cardiology,the Yangchun People's Hospital,Yangjiang 529600,China;Department of Laboratory,the Yangchun People's Hospital,Yangjiang 529600,China)
出处
《广东医科大学学报》
2021年第3期293-298,共6页
Journal of Guangdong Medical University
