急诊经皮冠状动脉介入治疗急性 ST 段抬高型心肌梗死患者平均血小板体积与心电图 ST 段回落的相关性研究

Association of mean platelet volume with ST-segment resolution in acute ST-segment elevation myocardial infarction patients treated with primary percutaneous coronary intervention

目的：探讨急诊经皮冠状动脉介入治疗 ST 段抬高型急性心肌梗死患者的平均血小板体积与心肌再灌注的相关性。方法入选162例成功行急诊 PCI 的 ST 段抬高型心肌梗死患者，根据术后2 h 心电图 ST 段的回落幅度分为 STR≥50％组和 STR ＜50％组，比较两组患者的平均血小板体积。采用多因素回归分析心电图 ST 段回落不良的相关因素。结果 MPV 升高是急性 ST 段抬高型心肌梗死患者急诊经皮冠状动脉介入治疗后2 h ST 段回落不良的独立危险因素。多因素回归分析显示，术前 MPV 升高、发病至开通罪犯血管时间延长、梗死相关动脉为左前降支和术后 TIMI 血流＜3级是 STEMI 患者术后心电图 ST 段回落不良的独立危险因素。结论急诊 PCI 术前MPV 的升高可作为术后 ST 段回落不良的预测指标之一。

Objective To investigate the relationship between mean platelet volume and myocar-dial reperfusion in acute ST-segment elevation myocardial infarction（STEMI）patients treated with pri-mary percutaneous coronary intervention（PCI）. Methods A total of 162 STEMI patients with primary PCI were enrolled in this study. The patients were divided into two groups according to ST-segment resolu-tion（STR）at 2 h after PCI：STR≥50% group and STR 〈 50% group,the MPV were compared. Predic-tors of poor STR were identified by multivariable logistic regression analysis. Results The patients with STR≥50% had significant higher MPV. In multivariable Logistic regression analysis,higher MPV before PCI was independently associated with STR≥50% . Other independent predictors were onset to balloon time,infarction related artery（LAD）and TIMI flow grade 〈 Ⅲ after PCI. Conclusions Higher MPV is an independent predictor of poor myocardial reperfusion in STEMI patients after PCI.