摘要
目的探讨血小板与淋巴细胞比值(PLR)在急性前壁心肌梗死后左室血栓形成中的临床价值。方法回顾性选取2017年1月至2021年7月于粤北人民医院明确诊断为急性前壁心肌梗死的131例患者作为研究对象,根据是否发生左室血栓(LVT)分为血栓组32例,对照组99例。入院时从肘正中静脉抽取血样用于测定生化和凝血四项指标,LVT由超声心动图或心脏声学造影诊断。结果单因素分析结果提示,血栓组和对照组患者的室壁瘤比例、血小板计数(PLT)、中性粒细胞计数(NEU)、PLR、左室射血分数(LVEF)比较,差异有统计学意义(P<0.05);多因素分析结果显示,PLR(β=0.075,OR=1.078,95%CI=1.025~1.134)、室壁瘤形成(β=2.193,OR=8.960,95%CI=1.252~64.111)是发生LVT的危险因素;LVEF(β=-0.145,OR=0.865,95%CI=0.784~0.953)是发生LVT的保护因素(P<0.05);受试者工作特征(ROC)曲线显示,PLR预测LVT最佳截点为215.35,曲线下面积(AUC)为0.756(95%CI=0.661~0.852,P<0.001),其灵敏度为0.563,特异度为0.818。结论在前壁心肌梗死的患者中,室壁瘤形成、PLR升高是发生LVT的独立危险因素,LVEF升高是发生LVT的保护性因素;PLR与LVT发生有关,在未来PLR可能是临床实践中判断LVT有价值的指标。
Objective To investigate the clinical value of platelet/lymphocyte ratio(PLR)in left ventricular thrombosis after acute anterior wall myocardial infarction.Methods A total of 131 patients with acute anterior myocardial infarction diagnosed with acute anterior myocardial infarction in Yuebei People′s Hospital from January 2017 to July 2021 were retrospectively selected as research objects,according to the occurrence of left ventricular thrombus(LVT),they were divided into thrombosis group(n=32)and control group(n=99).Blood samples were drawn from the median cubital vein on admission for the determination of biochemical and coagulation parameters.LVT is diagnosed by echocardiography or contrast echocardiography.Results Univariate analysis showed that there were significant differences in the proportion of ventricular aneurysm,platelet count(PLT),neutrophil count(NEU),PLR,left ventricular ejection fraction(LVEF)in thrombosis group and control group(P<0.05).Multivariate analysis showed that PLR(β=0.075,OR=1.078,95%CI=1.025-1.134),ventricular aneurysm formation(β=2.193,OR=8.960,95%CI=1.252-64.111)were risk factors for LVT occurence.LVEF(β=-0.145,OR=0.865,95%CI=0.784-0.953)was a protective factor for LVT occurrence(P<0.05).Receiver operation characteristic(ROC)curve showed the best cut-off point of PLR for predicting LVT was 215.35,the area under curve(AUC)was 0.756(95%CI=0.661-0.852,P<0.001),the sensitivity was 0.563,and the specificity was 0.818.Conclusion In patients with anterior myocardial infarction,aneurysm formation and elevated PLR are independent risk factors for the occurrence of LVT,and elevated LVEF is a protective factor for the occurrence of LVT.PLR is related to the occurrence of LVT,it is a valuable indicator for judging LVT in clinical practice.
作者
刘泽宇
冯应君
刘宣宣
LIU Zeyu;FENG Yingjun;LIU Xuanxuan(Department of Physical Diagnostics,Yuebei People′s Hospital,Guangdong Province,Shaoguan512026,China;Department of Cardiology,Yuebei People′s Hospital,Guangdong Province,Shaoguan512026,China)
出处
《中国当代医药》
CAS
2022年第25期18-21,共4页
China Modern Medicine
关键词
急性前壁心肌梗死
左室血栓形成
血小板淋巴细胞比值
室壁瘤
Acute anterior wall myocardial infarction
Left ventricular thrombosis
Platelet/lymphocyte ratio
Ventricular aneurysm
