摘要
目的探讨血小板形态参数与急性冠状动脉(冠脉)综合征(ACS)患者冠脉病变严重程度及预后的关系。方法选取收治的ACS患者123例(ACS组)和同期50例体检健康者(对照组),根据Gensini评分将ACS患者分为轻度冠脉病变组(38例)、中度冠脉病变组(49例)、重度冠脉病变组(36例),统计经皮冠脉介入治疗后1年患者预后情况。采用全自动血液分析仪检测血小板形态参数[血小板分布宽度(PDW)、平均血小板体积(MPV)和大血小板比率(P-LCR)]。通过Spearman相关法分析ACS患者血小板形态参数与Gensini评分的相关性,Logistic回归分析ACS患者不良预后的因素。受试者工作特征(ROC)曲线分析血小板形态参数对ACS患者不良预后的评估价值。结果与对照组比较,ACS组MPV、PDW、P-LCR升高(P均<0.05)。轻度、中度、重度冠脉病变组MPV、PDW、P-LCR依次升高(P均<0.05)。ACS患者MPV、PDW、P-LCR与Gensini评分呈正相关(rs分别为0.778、0.800、0.761,P均<0.05)。随访1年,123例ACS患者不良预后发生率为29.27%(36/123)。Killip分级≥Ⅱ级、Gensini评分增加和MPV、PDW、P-LCR升高为ACS患者不良预后的独立危险因素(P均<0.05)。MPV、PDW、P-LCR联合评估ACS患者不良预后的曲线下面积为0.924,大于MPV、PDW、P-LCR单独评估的0.771、0.765、0.777(P均<0.05)。结论ACS患者MPV、PDW、P-LCR升高,与冠脉病变程度加重和不良预后有关;MPV、PDW、P-LCR联合检测对ACS患者预后的评估价值较高。
Objective To investigate the relationships between platelet morphology parameters and the severity of coronary lesions and prognosis in patients with acute coronary syndrome(ACS).Methods Totally 123 patients with ACS(ACS group)and 50 physically examined healthy people in the same period(control group)were selected,and the patients with ACS were divided into the mild coronary artery lesion group(38 cases),moderate coronary artery lesion group(49 cases),and severe coronary artery lesion group(36 cases)based on the Gensini score,and the prognosis of pa⁃tients at 1 year after percutaneous coronary intervention was analyzed.Platelet morphological parameters[platelet distribu⁃tion width(PDW),mean platelet volume(MPV)and platelet-large cell ratio(P-LCR)]were measured by a fully automat⁃ed hematology analyzer.The correlation between platelet morphology parameters and Gensini score in ACS patients was an⁃alyzed by Spearman's correlation,the factors of poor prognosis in ACS patients were analyzed by Logistic regression,and the value of platelet morphology parameters in assessing the poor prognosis of ACS patients was analyzed by receiver operat⁃ing characteristic(ROC)curve.Results Compared with the control group,MPV,PDW,and P-LCR were elevated in the ACS group(all P<0.05).MPV,PDW,and P-LCR increased sequentially in the mild,moderate,and severe coronary lesion groups(all P<0.05).MPV,PDW,and P-LCR were positively correlated with Gensini scores in ACS patients(rs=0.778,0.800,and 0.761,respectively;all P<0.05).At 1-year follow-up,the incidence of poor prognosis was 29.27%(36/123)in 123 patients with ACS.Killip classification≥Ⅱ,increased Gensini score,and elevated MPV,PDW,and PLCR were independent risk factors for poor prognosis in patients with ACS(all P<0.05).The area under the curve of MPV,PDW,and P-LCR combined in assessment of poor prognosis in patients with ACS was 0.924,which was greater than that of MPV,PDW,and P-LCR alone,which was 0.771,0.765,and 0.777(all P<0.05).Conclusions Elevat⁃ed MPV,PDW,and P-LC
作者
崔颖超
刘杰
储毓舜
CUI Yingchao;LIU Jie;CHU Yushun(Department of Cardiology,Tianjin Beichen Hospital,Tianjin 300400,China)
出处
《山东医药》
CAS
2024年第22期10-15,共6页
Shandong Medical Journal
基金
天津市卫生健康科技项目(20ZXMFCY0078)。
关键词
急性冠状动脉综合征
血小板形态参数
病变严重程度
预后
acute coronary syndrome
platelet morphology parameters
severity of coronary lesion
prognosis
