Objective To investigate the relationship between platelet/lymphocyte ratio (PLR) and infarct associated artery occlusion in patients with acute ST-segment elevation myocardial infarction (ASTEMI).Methods From January 2015 to January 2017,a total of 235 patients with ASTEMI were selected in the Department of Cardiology,Renmin Hospital of Wuhan University,and they were divided into A group (with infarct related artery occlusion,TIMI 0-1 grade,n =129) and B group (without infarct related artery occlusion,TIMI 2-3 grade,n =106) according to TIMI grade.General information,coronary artery lesions related index,laboratory examination results and index of cardiac function were compared between the two groups,correlation between PLR and Gensini score was analyzed by Pearson correlation analysis in ASTEMI patients with infarct related artery occlusion,relation between PLR and infarct related artery occlusion was analyzed by multiple linear regression analysis in patients with ASTEMI,and ROC curve was drawn to evaluate the diagnostic value of PLR on infarct related artery occlusion in patients with ASTEMI.Results No statistically significant differences of male proportion,age,BMI,smoking rate,incidence of hypertension,hyperlipidaemia,left circumflex artery lesion or right coronary artery lesion was found between the two groups (P ＞0.05),while there were statistically significant differences of incidence of diabetes and left anterior descending branch lesion,number of stenosed coronary arteries and Gensini score (P ＜ 0.05).No statistically significant differences of WBC,NEUT,RBC,ALT,AST,BUN,Cr,TC,TG,HDL,LDL,FPG or LVEF was found between the two groups (P ＞0.05);Lym and UA of B group were statistically significantly higher than those of A group,PLT and PLR of B group were statistically significantly lower than those of A group,while LVEDD of B group was statistically significantly shorter than that of A group (P ＜ 0.05).Pearson correlation analysis results showed that,PLR was positively correlated with Gensini score in ASTEMI patients with infarct related artery occlusion (r =0.547,P ＜ 0.05).Multiple linear regression analysis results showed that,PLR was independently correlated with infarct related artery occlusion in patients with ASTEMI (regression coefficient was 0.218,standardized regression coefficient was 0.531,P ＜ 0.05).ROC curve showed that,AUC of PLR was 0.706 [95％ CI (0.639,0.773)] in diagnosing infarct related artery occlusion in patients with ASTEMI,the optimum truncation value was 105.54,the sensitivity was 92.2％,the specificity was 38.7％,the Youden index was 0.706.Conclusion PLR is significantly correlated with infarct related artery occlusion in patients with ASTEMI,has certain diagnostic value,can reflect the severity of coronary artery lesion in ASTEMI patients with infarct related artery occlusion to some extent.%目的 探讨血小板/淋巴细胞比值(PLR)与急性ST段抬高型心肌梗死(ASTEMI)患者梗死相关动脉(IRA)闭塞的关系.方法 选取武汉大学人民医院心内科2015年1月-2017年1月收治的ASTEMI患者235例,根据TIMI分级分为IRA闭塞组(TIMI分级0～1级)129例和IRA非闭塞组(TIMI分级2～3级)106例.比较两组患者一般资料、冠状动脉病变情况、实验室检查指标及心功能指标,PLR与IRA闭塞组患者Gensini积分的相关性分析采用Pearson相关性分析,PLR与ASTEMI患者IRA闭塞的关系分析采用多元线性回归分析,绘制ROC曲线以评价PLR对ASTEMI患者IRA闭塞的诊断价值.结果两组患者男性比例、年龄、体质指数(BMI)、吸烟率、高血压发生率、高脂血症发生率、左回旋支(LCX)病变发生率及右冠状动脉(RCA)病变发生率比较,差异无统计学意义(P＞0.05);两组患者糖尿病发生率、左前降支(LAD)病变发生率、冠状动脉病变支数及Gensini积分比较,差异有统计学意义(P＜0.05).两组患者白细胞计数(WBC)、中性粒细胞计数(NEUT)、红细胞计数(RBC)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、尿素氮(BUN)、肌酐(Cr)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、空腹血糖(FPG)及左心室射血分数(LVEF)比较,差异无统计学意义(P＞0.05);IRA非闭塞组患者淋巴细胞计数(Lym)、尿酸(UA)高于IRA闭塞组,血小板计数(PLT)及PLR低于IRA闭塞组,左心室舒张末期内径(LVEDD)短于IRA闭塞组(P＜0.05).Pearson相关性分析结果显示,PLR与IRA闭塞组患者Gensini积分呈正相关(r=0.547,P＜0.05).多元线性回归分析结果显示,PLR与ASTEMI患者IRA闭塞独立相关(回归系数=0.218,标准化回归系数=0.531,P＜0.05).绘制ROC曲线发现,PLR诊断ASTEMI患者IRA闭塞的曲线下面积为0.706[95％ CI (0.639,0.773)],最佳截断值为105.54,灵敏度为92.2％,特异度为38.7％,约登指数为0.706.结论 PLR与ASTEMI患者IRA闭塞有关,其对ASTEMI患者IRA闭塞具有一定的诊断价值,可在一定程度上反映IRA闭塞的ASTEMI患者冠状动脉病变严重程度.
展开▼
