白细胞计数与平均血小板体积比值对于急性心肌梗死患者PCI术后主要不良事件的预测价值

摘要

Objective To evaluate the predictive value of WBC count to mean platelet volume(MPV) ratio(WMR) for main adverse cardiovascular events(MACE) in the patients with acute myocardial infarction(AMI).Methods The clinical data in 90 cases of AMI were retrospectively analyzed.The patients were divided into the MACE group(39 cases) and non-MACE group(51 cases) according to the MACE occurrence situation at 2 years after PCI.The fluctuation situation of WMR was compared between before and after PCI treatment,and its correlation with MACE occurrence was analyzed.Results The WMR level after PCI in the nonMACE group was significantly decreased [(1 405.6±151.2) × 10-6/L2 vs.(961.4±122.1) × 10-6/L2,P＜0.05];but no obvious decrease of WMR was found in the MACE group(P＞0.05).△WMR in the MACE group was significantly lower than that in the non-MACE group[(141.5±29.8) × 10-6/L2 vs.(499.5±94.3)× 10-6/L2,P＜0.05].△WMR was negatively correlated with the MACE occurrence rate at postoperative 2 years (r =-0.633,P＜ 0.05).The area under the curve (AUC) of MACE was 0.812,95 ％CI was 0.723-0.898,the cut-off value was 100.2,the sensitivity was 81.4 ％ and the specificity was 76.2 ％.Conclusion Dynamic observation of WMR change before and after PCI is conducive to the early assessment of MACE in the patients with AMI.%目的 探讨白细胞计数与平均血小板体积比值(WMR)对于急性心肌梗死(AMI)患者主要不良事件(MACE)的预测价值.方法 回顾性分析90例AMI患者临床资料,根据急诊冠状动脉介入治疗(PCI)术后2年MACE发生情况,分为MACE组(39例)和非MACE组(51例).比较PCI治疗前后WMR水平波动情况与MACE发生的相关性.结果 PCI术后可见非MACE组患者WMR下降较为明显[(1 405.6±151.2)×10-6/L2 vs.(961.4±122.1)×10-6/L2,P＜0.05];而MACE组PCI术后来见明显下降(P＞0.05).MACE组△WMR明显低于非MACE组[(141.5±29.8)×10-6/L2 vs.(499.5±94.3)×10-6/L2,P＜0.05].△WMR与术后2年MACE发生率呈负相关(r=-0.633,P＜0.05).△WMR的曲线下面积为0.812,95％CI为0.723～0.898,cut-off值为100.2,敏感性81.4％,特异性76.2％.结论 动态观察PCI术前术后WMR改变有助于AMI患者MACE的早期评估.