摘要
目的通过研究阐明血常规相关指标能否成为预测急性ST段抬高型心肌梗死(ST-segment Elevation Myocardial Infarction,STEMI)急诊经皮冠状动脉介入术(Percutaneous Coronary Intervention,PCI)患者术中慢/无复流情况。方法依据入选标准及排除标准,回顾性连续的选取2018-01至2020-12在我院心血管内科住院治疗且符合2016年中国经皮冠状动脉介入治疗指南中诊断及治疗标准的STEMI行急诊PCI的457例患者为研究对象,按照判定标准将患者分为两组,A组(无复流组TIMI≤2级)62例和B组(正常复流组TIMI 3级)395例。所有入选患者记录其基本信息,入院时血压,心率,既往史(包括高血压以及糖尿病)、首次医疗接触时间至血管开通时间;记录患者术前的生化指标、血常规指标、术中TIMI分级、急性心梗罪犯血管等结果,对两组间相关指标进行比较。通过Logistic多因素回归分析发现STEMI急诊PCI患者术中发生的危险因素。结果(1)A组中性粒细胞绝对值、中性粒细胞淋巴细胞百分比高于B组[4.02(3.62,6.52)VS 5.02(3.77,7.01);2.35(1.71,4.92)VS 3.46(2.01,7.84);P<0.05]。A组淋巴细胞绝对值低于正常血流组(1.64±0.69 VS 1.28±0.31,P<0.05)。(2)两组研究对象在肾功能、血脂、白细胞计数、红细胞计数、血小板计数、血红蛋白、急性心梗罪犯血管等指标相比,差异无统计学意义。(3)Logistic单因素回归分析显示术前中性粒细胞绝对值、淋巴细胞绝对值、中性粒细胞淋巴细胞百分比均是STEMI患者急诊PCI术中发生慢/无复流现象的危险因素。结论术前中性粒细胞绝对值、淋巴细胞绝对值、中性粒细胞淋巴细胞百分比有助于预测STEMI患者急诊PCI术中慢/无复流现象的发生。
Objective To investigate the prognostic of blood routine indexes for the slow/no-reflow phenomenon in patients with ST-segment Elevation Myocardial Infarction(STEMI)in primary Percutaneous Coronary Intervention(PCI).Methods According to the inclusion and exclusion criteria,a retrospective analysis was carried out to continuously select 457 patients who were hospitalized in the Department of Cardiovascular Medicine of our hospital from Jan 2018 to Dec 2020 and conformed to the Guidance to the Diagnosis and Treatment Standard for STEMI PCI released in China in 2016.Patients were divided into two groups according to the TIMI blood flow grade in primary PCI.Group A(no-reflow,TIMI≤2)had 62 patients and group B(normal blood flow,TIMI=3)had 395 patients.The patients’basic information,blood pressure,heart rate,previous medical history(including hypertension and diabetes),and the first medical contact-to-balloon time were recorded at the time of admission.The biochemical indicators,blood routine indexes,TIMI blood flow grade,and the culprit vessel of acute myocardial infarction before intervention were recorded and compared between the groups.Logistic single-factor regression analysis was adopted to detect risk factors for slow/no-reflow phenomenon in patients with STEMI in primary PCI.Results(1)The absolute neutrophil count and neutrophil/lymphocyte ratio of group A were significantly higher than those of group B group[4.02(3.62,6.52)VS 5.02(3.77,7.01);2.35(1.71,4.92)VS 3.46(2.01,7.84);P<0.05].But the absolute lymphocyte count in group A was significantly lower than that in the normal blood flow group(1.64±0.69 VS 1.28±0.31,P<0.05).(2)The two groups had no statistical differences between renal function,blood lipids,white blood cell count,red blood cell count,platelets count,hemoglobin,and culprit vessel of acute myocardial infarction(P>0.05).(3)Logistic single-factor regression analysis showed that the preoperative absolute neutrophil count,absolute lymphocyte count,and neutrophil/lymphocyte ratio were all the risk
作者
李丽
周彤
LI Li;ZHOU Tong(Department of Cardiovascular Medicine,Inner Mongolia Baogang Hospital,Baotou 014010,China;Emergency Medicine Department,Inner Mongolia Baogang Hospital,Baotou,014010,China)
出处
《中华灾害救援医学》
2021年第12期1381-1384,1408,共5页
Chinese Journal of Disaster Medicine
基金
包头市科技计划项目(2017S2001-1-01)。
关键词
急诊PCI
中性粒细胞绝对值
淋巴细胞绝对值
中性粒细胞淋巴细胞百分比
慢/无复流
primary Percutaneous Coronary Intervention
absolute neutrophil count
absolute lymphocyte count
neutrophil/lymphocyte ratio
slow/no-reflow phenomenon
