血小板参数与急性冠脉综合征的临床分型和病变程度的相关性研究

Relation between platelet parameters and clinical classification and severity of acute coronary syndrome

目的探讨血小板参数与急性冠脉综合征(ACS)患者临床分型和冠状动脉病变严重程度的相关性。方法入选ACS患者262例,其中急性ST段抬高型心肌梗死(STEMI)组167例,急性非ST段抬高型心肌梗死(NSTEMI)组30例,不稳定型心绞痛(UAP)组65例。采用Gensini评分定量评估冠状动脉病变严重程度。比较3组临床资料,分析Gensini评分与各临床指标的相关性。结果STEMI组和NSTEMI组的年龄、平均血小板体积(MPV)、血小板分布宽度(PDW)和高敏C反应蛋白(hs-CRP)水平明显高于UAP组(P<0.05);STEMI组MPV和PDW水平明显高于NSTEMI组(P<0.05);ACS患者MPV、PDW和hs-CRP水平与冠状动脉病变支数和Gensini评分呈正相关。结论 MPV和PDW水平与ACS患者冠状动脉病变严重程度呈正相关,故可以作为ACS患者冠状动脉病变严重程度的预测因素。

Objective To investigate the association between platelet parameters and the clinical classification and the severity of coronary artery disease in patients with acute coronary syndrome（ACS）.Methods A total of 262 patients with ACS were divided into STEMI group （n=167）,NSTEMI group （n=30）and UAP group （n=65）. The severity of coronary stenosis was quantitated by Gensini score system.The clinical data of three groups were compared,the correlation between Gensini score and clinical indexes were analyzed.Results There were significantly higher levels of age,hsCRP,mean platelet volume and platelet distribution width in STEMI group and NSTEMI group than in UAP group（P 〈0.05）,MPV and PDW in STEMI group were significantly higher than those of NSTEMI group（P〈0.05 ）.Correlation and regression analysis showed there were significant positive correlations between MPV,PDW and hsCRP levels and coronary lesions and Gensini score in all patients with ACS.Conclusion MPV and PDW levels were significantly different in patients with different ACS types,and the levels of MPV and PDW were positively correlated with the severity of coronary artery lesions in patients with ACS,which could be used as predictors of the severity of coronary artery lesions in patients with ACS.