骨髓增殖性肿瘤患者并发急性冠脉综合征相关因素分析

The association factors of acute coronary syndrome in patients with myeloproliferative neoplasms

目的通过病例总结,分析骨髓增殖性肿瘤(MPN)患者中急性冠脉综合征(ACS)病例的特征,探讨其相关因素。方法选择2004年至2014年于北京协和医院住院并确诊MPN的125例患者,收集其人口学资料(年龄,性别)、心血管病危险因素(吸烟、高血压病、高脂血症和糖尿病)等信息,分析ACS病例的基本特征,通过Spearman相关性分析寻找ACS的可能相关因素。结果共7例ACS病例(发病率为5.6%);ACS组与非ACS组相比,既往冠心病史、血红蛋白(HGB)(P<0.001)和白细胞(WBC)(P<0.05)3个项目存在显著性差异;分析发现ACS与既往冠心病史、WBC计数呈显著正相关(P<0.01)。结论 ACS是MPN人群主要血栓并发症之一;既往冠心病史,外周血白细胞增多可能与MPN人群的ACS相关。

Objective Through summarizing cases, analyze the characteristics of acute coronary syndrome patients in myeloproliferative neoplasms （MPN） population, and investigate the association factors of acute coronary syn- drome （ACS）. Methods In total 125 cases of hospitalized patients diagnosed of MPN in Peking Union Medical College Hospital in 2004 -2014 were included in this study. The information of demographic data （age, gender）, cardiovascular risk factors （smoking, hypertension, hyperlipidemia, diabetes）, previous history of thrombosis, previous history of coronary artery disease, previous history of other peripheral vascular disease, previous hydroxyurea or anti-platelet therapy, and laboratory parameters （complete blood count, coagulation functions） was collected and further analyzed for basic characteristics of ACS cases; Spearman correlation analysis was applied to explore association factors of acute coronary syndromes. Results A total of 7 cases developed ACS （incidence 5.6% ）. Between ACS and non-ACS patients, significant difference existed in previous history of coronary artery disease （ 18.6% vs 85.7%, P 〈0. 001, hemoglobin level （ 141 ±45 vs 171 ±13, P 〈0. 001 ） and leukocyte count （10. 76 ± 8.09 vs 17.88 ± 8.79, P 〈 0.05）. Spearman analysis found significant positive correlations between ACS and previous history of coronary artery disease and leukocyte count （correlation coefficients were 0. 361,0. 271, respectively; P 〈 0. 05）. Conclusion ACS is one of the major thrombosis complications in MPN population. Previous history of coronary artery disease and leukocytosis probably associated with ACS in MPN population.