摘要
目的探讨老年急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)术前血小板分布宽度(PDW)、中性粒细胞/淋巴细胞(NLR)与院内主要不良心血管事件(MACE)的关系。方法回顾性分析138例在笔者医院行急诊PCI术治疗的老年STEMI患者,术后院内发生MACE者23例,未发生MACE者115例。测定PCI术前的PDW、NLR,采用多元Logistic回归模型评价PDW、NLR与MACE的关系。根据PDW、NLR绘制ROC曲线,计算曲线下面积(AUC),分析PDW、NLR对MACE发生的预测价值。结果发生MACE患者和未发生MACE患者的PDW分别是17.94±6.59、11.75±3.53,NLR分别是6.28±2.87、3.26±1.61,发生MACE患者的PDW、NLR均高于未发生MACE患者(P均<0.05)。Logistic回归分析显示,PDW、NLR与MACE的发生相关(OR=4.307,95%CI:1.564~11.864,P=0.005;OR=5.183,95%CI:1.841~14.591,P=0.002)。同时,ROC分析显示,PDW、NLR预测心血管事件的曲线下面积(AUC)分别是0.772、0.851,敏感度分别为65.2%、87.0%,特异性分别为80.9%、79.1%。结论老年STEMI患者PCI术前高PDW、NLR水平对院内MACE的发生有一定预测价值。
Objective To investigate the relationship between platelet distribution width(PDW),neutrophil/lymphocyte(NLR)and major adverse cardiovascular events(MACE)in elderly patients with acute ST segment elevation myocardial infarction(STEMI).Methods Totally 138 elderly STEMI patients who underwent PCI in our hospital were analyzed retrospectively.There were 23 cases with mace and 115 cases without mace.PDW and NLR were measured before PCI,and the relationship between PDW,NLR and mace was evaluated by multiple Logistic regression model.According to the ROC curve drawn by PDW and NLR,the area under the curve(AUC)was calculated,and the predictive value of PDW and NLR to mace occurrence was analyzed.Results PDW and NLR were 17.94±6.59,11.75±3.53,6.28±2.87 and 3.26±1.61,respectively,in patients with mace and those without mace(P<0.05).Logistic regression analysis showed that PDW and NLR were correlated with mace(OR=4.307,95%CI:1.564-11.864,P=0.005;OR=5.183,95%CI:1.841-14.591,P=0.002).At the same time,ROC analysis showed that AUC of PDW and NLR was 0.772 and 0.851,respectively,with sensitivity of 65.2%and 87.0%.The specificity was 80.9%and 79.1%respectively.Conclusion The high level of PDW and NLR in the elderly patients with STEMI before PCI can predict the occurrence of mace in hospital.
作者
陈小丽
李建国
任艳琴
Chen Xiaoli;Li Jianguo;Ren Yanyin(Department of Cardiovascular Medicine,Fenyang Hospital Affiliated to Shanxi Medical University,Shanxi 032200,China)
出处
《医学研究杂志》
2020年第6期96-99,共4页
Journal of Medical Research
基金
山西省重点研发计划项目(201603D321062)。
