摘要
目的探讨冠心病经皮冠状动脉介入术(PCI)术后合并肺部感染患者外周血红细胞分布宽度(RDW)、中性粒细胞淋巴细胞比值(NLR)及凝血纤溶因子水平变化,并分析其可能的机制及与预后的相关性。方法回顾性分析2018年1月至2020年3月在该院行PCI的78例冠心病患者临床资料,根据其术后是否发生肺部感染分为感染组(35例)和非感染组(43例)。比较两组患者RDW、NLR、凝血纤溶系统指标水平变化及血小板中L-Arg/NOS/NO信号通路表达情况,采用Logistic回归分析患者预后不良的影响因素及上述指标在评估患者预后方面的临床价值。结果感染组患者RDW、NLR均明显高于非感染组(P<0.001);与非感染组比较,感染组患者凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)明显延长,纤维蛋白原(FIB)、D-二聚体(D-D)及组织纤溶酶原激活物(t-PA)、组织纤溶酶原抑制物(PAI)水平均明显升高,抗凝血酶-Ⅲ(AT-Ⅲ)活性及纤溶酶原(PLG)水平均明显降低(P<0.05);感染组患者血小板中L-Arg转运量、NOS活性及NO水平均明显低于非感染组(P<0.05)。Logistic回归分析结果显示,外周血RDW、NLR、PT、APTT及FIB、D-D、t-PA、PAI水平均是冠心病PCI术后合并肺部感染患者预后不良的影响因素(P<0.05),且在评估患者预后方面均具有一定的临床价值(P<0.05)。结论冠心病PCI术后合并肺部感染患者RDW、NLR及凝血纤溶系统均表现异常,且与患者预后有一定相关性。
Objective To investigate the changes of red blood cell distribution width(RDW),neutrophil lymphocyte ratio(NLR)and coagulation fibrinolysis index levels in patients with coronary heart disease complicated with pulmonary infection after PCI,and to analyze the possible mechanism and the correlation with prognosis.Methods The clinical data of a total of 78 patients with coronary heart disease who underwent PCI in the hospital from January 2018 to March 2020 were retrospectively analyzed,they were divided into the infection group(35 cases)and non-infection group(43 cases)according to whether postoperative pulmonary infection occurred.The changes of RDW,NLR,coagulation and fibrinolysis system indexes and the expression of L-Arg/NOS/NO signaling pathway in platelets were compared between the two groups,Logistic regression was used to analyze the influencing factors of poor prognosis and the clinical value of the above indicators in evaluating the prognosis of patients.Results The RDW and NLR of the infected group were significantly higher than those of the non-infected group(P<0.001).Compared with the non-infected group,the PT and APTT of the infected group prolonged significantly,the levels of FIB,D-D,t-PA and PAI increased significantly,AT-Ⅲactivity and PLG level reduced significantly(P<0.05).The L-Arg transport,NOS activity and NO level in platelets of infected patients were significantly lower than non-infected groups(P<0.05).Logistic regression analysis showed that the levels of RDW,NLR,PT,APTT,FIB,D-D,t-PA and PAI in peripheral blood were the influencing factors of poor prognosis in patients with coronary heart disease complicated with pulmonary infection after PCI(P<0.05),and had certain clinical value in evaluating the prognosis of patients(P<0.05).Conclusion The levels of RDW,NLR and coagulation and fibrinolysis system are abnormal,and some indexes are correlated with the prognosis of patients with coronary heart disease complicated with pulmonary infection after PCI.
作者
李中华
朴奇彦
周秀明
王征
LI Zhonghua;PIAO Qiyan;ZHOU Xiuming;WANG Zheng(Department of Cardiovascular,Qianwei Hospital of Jilin Province,Changchun,Jilin 130000,China)
出处
《国际检验医学杂志》
CAS
2021年第18期2267-2271,共5页
International Journal of Laboratory Medicine
关键词
经皮冠状动脉介入术
肺部感染
红细胞分布宽度
中性粒细胞淋巴细胞比值
凝血纤溶系统
预后
percutaneous coronary intervention
pulmonary infection
red blood cell distribution width
neutrophil-lymphocyte ratio
coagulation and fibrinolysis system
prognosis
