摘要
目的 分析急性冠状动脉综合征(ACS)患者的白细胞计数与平均血小板体积比值(WMR)和血小板与淋巴细胞比值(PLR)与冠状动脉病变严重程度的相关性,并探究WMR、PLR对冠状动脉狭窄程度及院内主要不良心血管事件(MACE)的预测价值。方法 本研究为回顾性分析,收集了2020年12月至2022年11月在新疆医科大学第一附属医院急诊抢救室因胸痛、胸闷首次诊断为ACS并接受经皮冠状动脉介入(PCI)治疗的391例患者数据。根据临床分型,将患者分为不稳定型心绞痛(UA)组147例,非ST段抬高型心肌梗死(NSTEMI)组114例,及ST段抬高型心肌梗死(STEMI)组130例。进一步按照是否出现院内MACE分为MACE组106例和无MACE组285例。依据Gensini评分中位数将患者分为重度病变组(Gensini评分≥53分)196例和轻度病变组(Gensini评分<53分)195例。比较各组患者的基本资料及实验室检查指标,使用二元多因素logistic回归模型筛选冠状动脉狭窄程度及院内MACE的影响因素,分析WMR、PLR与冠状动脉狭窄程度的相关性,并通过ROC曲线分析WMR、PLR及其联合对冠状动脉狭窄程度及院内MACE的预测诊断价值。结果 WMR和PLR与ACS患者冠状动脉狭窄程度均呈正相关(r=0.336,P<0.001;r=0.374,P<0.001)。二元多因素logistic回归分析表明,WMR和PLR均为冠状动脉狭窄程度和院内MACE的独立危险因素。ROC曲线结果显示,WMR、PLR及两者联合预测院内MACE的AUC分别为0.748、0.722和0.792;预测冠状动脉狭窄程度的AUC分别为0.694、0.716和0.770。结论 ACS患者入院早期WMR和PLR与冠状动脉狭窄程度呈正相关,并且具有预测院内MACE及冠状动脉狭窄程度的临床价值,其联合使用在诊断效果上更为优越。
Objective To explore the correlation between white blood cell count to mean platelet volume ratio(WMR)and platelet to lymphocyte ratio(PLR)with the severity of coronary artery disease in patients with acute coronary syndrome(ACS)and the predictive value of WMR and PLR for the major adverse cardiovascular events(MACE)during the hospitalization.Methods Data from 391 patients who were first diagnosed with ACS due to chest pain and chest tightness and received percutaneous coronary intervention(PCI)treatment in the emergency room of the First Affiliated Hospital of Xinjiang Medical University from December 2020 to November 2022 were recored.Based on the clinical classification,147 cases were divided into the unstable angina(UA)group,114 cases into the non-ST-segment elevation myocardial infarction(NSTEMI)group and 130 cases into the ST-segment elevation myocardial infarction(STEMI)group.Further,the patients were divided into a MACE group with 106 cases and a non-MACE group with 285 cases based on whether MACE occurred during hospitalization.According to the median Gensini score,196 cases were divided into a severe lesion group(Gensini score≥53)and 195 cases into a mild lesion group(Gensini score<53).The basic data and laboratory test indicators of patients in each group were compared.Binary multivariate logistic regression models were used to screen for the influencing factors of coronary artery stenosis and in-hospital MACE and analyze the correlation between WMR and PLR and the degree of coronary artery stenosis;and the ROC curve was used to assess the predictive diagnostic value of WMR and PLR,and their combination for the degree of coronary artery stenosis and in-hospital MACE.Results Both WMR and PLR were positively correlated with the degree of coronary artery stenosis in ACS patients(r=0.336,P<0.001;r=0.374,P<0.001).Multivariate logistic regression analysis showed that both WMR and PLR were independent risk factors for the degree of coronary artery stenosis and in-hospital MACE.ROC curve results indicated that the AUCs for predicting in-hospital MACE using WMR,PLR,and their combination were 0.748,0.722,and 0.792,respectively;the AUCs for predicting the degree of coronary artery stenosis were 0.694,0.716,and 0.770,respectively.Conclusion The early WMR and PLR at admission in ACS patients are positively correlated with the degree of coronary artery stenosis and have clinical value in predicting in-hospital MACE and the degree of coronary artery stenosis.Their combined test is more effective in diagnostic outcomes.
作者
王琼
张笑玮
刘志强
WANG Qiong;ZHANG Xiao-wei;LIU Zhi-qiang(General Department of Cardiology,Heart Center,The First Affiliated Hospital of Xinjiang Medical University,830000 Urumqi,China)
出处
《中国心血管病研究》
CAS
2024年第9期795-802,共8页
Chinese Journal of Cardiovascular Research
基金
国家杰出青年科学基金(2022D01E23)。
