血小板/淋巴细胞比值评估老年男性急性心肌梗死后新发房颤的应用价值

Platelet/lymphocyte ratio in evaluating new-onset atrial fibrillation after acute myocardial infarction in elderly male patients

目的研究血小板/淋巴细胞比值(platelet to lymphocyte ratio,PLR)对评估老年男性急性心肌梗死(acute myocardial infarction,AMI)患者住院期间新发房颤(new onset atrial fibrillation,NOAF)的临床价值。方法以2014-01至2018-12于某院心血管内科就诊的241例老年男性AMI患者为研究对象。根据入院时是否发生NOAF,分成房颤组(n=40)和非房颤组(n=201)。搜集两组患者病历资料,并通过Logisitic回归及受试者工作特征(ROC)曲线分析PLR对老年男性AMI患者NOAF发生的预测价值。结果(1)经Logisitic回归分析显示:血清三酰甘油(TG)、左心室射血分数(LVEF)、PLR均是老年男性AMI患者入院后NOAF发生的独立危险因素(P<0.05)。(2)ROC曲线分析显示:PLR预测老年男性急性AMI入院后NOAF的最佳截点为248.11,预测的敏感性为87.90%,特异性为95.9%,AUC曲线下面积为0.969(95%CI:0.939~0.9998;P<0.01)。结论PLR评估老年男性AMI患者NOAF的发生具有一定的临床应用价值。

Objective To study the applicability of the platelet to lymphocyte ratio(PLR)in evaluating the new onset atrial fibrillation among elderly male patients with acute myocardial infarction(AMI)during hospitalization.Methods A total of 241 elderly male patients with AMI who were treated in the Department of Cardiology of a hospital between January 2014 and December 2018 were included in this study.These patients were divided into the atrial fibrillation group and the non-atrial fibrillation group based on the occurrence of NOAF during admission.The medical records of the two groups of patients were collected.Logistic regression analysis and the receiver operating characteristic(ROC)curve were used to analyze the potential of PLR to predict the occurrence of NOAF in elderly male AMI patients.Results(1)Logistic regression analysis showed that serum triglyceride(TG),left ventricular ejection fraction(LVEF),and PLR were independent risk factors for NOAF in elderly male AMI patients after admission(P<0.05).(2)ROC curve analysis showed that the best cutoff point for PLR to predict NOAF in elderly male patients of AMI after admission was 248.11.The sensitivity of prediction was 87.90%,the specificity was 95.9%,and the area under the AUC curve was 0.969(95%CI:0.939~0.9998;P<0.001).Conclusions PLR is significantly related to the occurrence of NOAF in elderly male AMI patients.