摘要
目的探讨血小板-淋巴细胞比率(PLR)预测非ST段抬高型急性心肌梗死(NSTEMI)患者左心室收缩功能障碍(LVSD)的准确性。方法选取2013年1月至2014年1月期间我院收治的NSTEMI患者98例作为观察组,另选取30例ST段抬高型急性心肌梗死患者(STEMI组)和30例同龄同期健康查体者作为对照,统计三组入选次日血小板和淋巴细胞计数并计算PLR。观察组入选时均无LVSD且均每3个月随访1次,共随访1年,随访时采用心脏超声检查射血分数(EF)和左心室舒张期末容积(LVEDV),并根据检测结果将观察组分为LVSD组(EF≤50%,n=63)和非LVSD组(EF>50%,n=35)。比较LVSD组和非LVSD组PLR,采用Pearson相关性分析法分析PLR与NSTEMI患者LVSD发生率的关系,并采用ROC曲线分析PLR预测NSTEMI患者LVSD的准确性。结果观察组PLR与STEMI组比较差异无统计学意义(P>0.05)。与健康对照组比较,观察组血小板计数升高,淋巴细胞计数降低,观察组PLR明显升高,差异有统计学意义(P<0.05)。LVSD组PLR最低值为66.86,最高值为744.68,平均PLR为169.78±44.96;非LVSD组PLR最低值为22.68,最高值为324.55,平均PLR为100.47±32.67,两组PLR最低值、最高值及平均值比较差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,PLR与NSTEMI患者LVSD发生率呈显著正相关(r=0.876,P<0.01)。阈值为474.58时PLR预测NSTEMI患者LVSD的ROC曲线下面积、敏感度、特异度和准确性均较高,PLR预测NSTEMI患者LVSD的价值良好。结论 PLR在NSTEMI患者中明显升高且与LVSD发生率相关,PLR预测NSTEMI患者LVSD的价值良好,且阈值为474.58时预测效果最优,因此对于出现PLR明显升高的NSTEMI患者需警惕其LVSD的发生并尽早进行干预以改善患者预后。
Aim To investigate the accuracy of platelet-lymphocyte ratio（ PLR） predicting left ventricular systolic dysfunction（ LVSD） in patients with non ST-elevation acute myocardial infarction（ NSTEMI）. Methods 98 NSTEMI patients in our hospital from January,2013 to January,2014 were selected as the observation group,and another 30 ST-elevation acute myocardial infarction（ STEMI） patients and 30 healthy persons with the same age in the same period were selected as the control group. Platelets and lymphocyte count of 3 groups the day after being included in the experiment were detected and PLR was calculated. All the patients in the observation group had no LVEF and were followed up every 3 months,and the total follow up period was 1 year. In follow up,ejection fraction（ EF） and left ventricular end diastolic volume（ LVEDV） of the observation group were tested by cardiac ultrasound and divided into LVSD group（ EF≤50%,n =63） and non-LVSD group（ EF 〉50%,n = 35） according to EF. PLR of LVSD group and non-LVSD group were compared. Pearson correlation analysis was used to analyze the relationship between PLR and LVSD incidence of NSTEMI patients and ROC curve was used to analyze the predict accuracy of PLR on LVSD of NSTEMI patients. Results PLR of observation group and STEMI group had no statistical significance（ P〉0. 05）. Compared with control group,platelet count and PLR of observation group was higher while lymphocyte count of observation group was lower,and the difference was statistically significant（ P〈0. 05）. The lowest,highest and average PLR of LVSD group were 66. 86,744. 68 and 169. 78 ± 44. 96 respectively,which were higher than the 22. 68,324. 55 and 100. 47 ± 32. 67 of the non-LVSD group,and the difference had statistical significance（ P〈0. 05）. Pearson correlation analysis results showed that PLR and LVSD incidence of NSTEMI patients was significantly and positively correlated（ r = 0. 876,P〈0. 01）. Area under the ROC curve,sensitivity,specificity and accuracy of PLR（ 474. 58） predicting LVSD of NSTEMI patients were high,which mean that prediction value of PLR on LVSD of NSTEMI patients was good. Conclusions PLR in NSTEMI patients was significantly elevated and associated with the incidence of LVSD of NSTEMI patients. Predict value of PLR on LVSD of NSTEMI patients was good and prediction value of PLR value as 474. 58 was the best,thus NSTEMI patients with high PLR should be alert to LVSD and intervened as early as possible in order to improve the prognosis of patients.
出处
《中国动脉硬化杂志》
CAS
北大核心
2015年第8期802-806,共5页
Chinese Journal of Arteriosclerosis
基金
广东省社会发展领域科技计划项目(20120318043)
佛山市医学类科技局攻关项目(201208307)
