血小板体积分布宽度与急性冠状动脉综合征患者冠状动脉病变严重程度的相关性

Relationship Between Platelet Distribution Width and the Extent of Coronary Artery Disease in Patients With Acute Coronary Syndrome After Percutaneous Coronary Intervention

目的研究评估血小板体积分布宽度(PDW)与行经皮冠状动脉介入(PCI)治疗的急性冠状动脉综合征(ACS)患者严重冠状动脉病变的相关性。方法连续纳入自2013年1月至12月于中国医学科学院阜外医院行PCI治疗的6431例ACS患者,急诊室采血或空腹12h后采血检测PDW,使用三分位法将PDW值分为3组,组1:PDW≤11.4%(2113例);组2:PDW11.4-12.9%(2150例);组3:PDW>12.9%(2168例)。严重冠状动脉病变定义为左主干和/或三支病变。同时计算SYNTAX积分评估冠状动脉病变严重程度。无再流定义为术后TIMI血流0或1级。采用多因素logistic回归分析PDW与严重冠状动脉病变的关系。结果 PDW不同组之间,严重冠状动脉病变(p=0.899)、冠脉病变SYNTAX积分(p=0.923)、术后无再流发生率(p=0.377)均无显著差异。多变量Logistic回归分析表明,PDW与ACS患者严重冠状动脉病变无明显相关[OR(95%CI)=1.003(0.978-1.029),p=0.821]。结论 PDW与接受PCI治疗的ACS患者严重冠状动脉病变无明显相关。

Objective To evaluate the relationship between platelet distribution width（PDW） and the extent of coronary artery disease（CAD）in patients received percutaneous coronary intervention（PCI） because of acute coronary syndrome（ACS）. Methods We consecutively enrolled6431 patients who received PCI because of ACS in Fu Wai Hospital（National Center for Cardiovascular Diseases, Beijing, China） from Jan 2013 to Dec 2013. Severe coronary artery disease was defined as LM and/or trivessel disease. SYNTAX score was also used to assess the extent of CAD. Results We grouped patients according to tertiles values of PDW（=11.4;12.9）. No significant difference was observed between PDW and the extent of CAD（p=0.899）,SYNTAX score（p=0.923）, no-reflow phenomenon after PCI（p=0.377）. Multivariable Logistic regression also showed no relationship between PDW and extent of CAD[OR（95%CI）= 1.003（0.978-1.029）,p=0.821]. Conclusion PDW was not significantly related with the extent of CAD in patients with ACS after PCI.