中性粒/淋巴细胞对急性心肌梗死自发再通的预测价值

Predictive Value of Neutrophil/Lymphocyte Ratio to the Spontaneous Recanalization of Actue Myocardial Infarction

目的研究中性粒细胞/淋巴细胞(neutrophil to lymphocyte ratio,NLR)与急性ST段抬高型心肌梗死(ST elevation myocardial infarction,STEMI)患者梗死相关动脉(infarction related artery,IRA)自发再通的关系。方法回顾性分析2013年6月—2017年1月行急诊冠状动脉介入术(percutaneous coronary intervention,PCI)的STEMI患者471例,根据冠状动脉造影(cornary arteriongraphy,CAG)结果,分为自发再通(spontaneous reperfusion,SR)组117例,未自发再通(none spontaneous reperfusion,NSR)组354例。对患者临床基本资料等进行分析。结果 SR组抗血小板药物使用比例高于NSR组,而NLR、HS-CRP、CTn I、CK-MB、LDL-C低于NSR组。Logistic回归分析提示应用抗血小板药物、HSCRP、NLR<6.3是SR的独立预测因素,NLR对STEMI患者冠脉SR的ROC曲线最佳截点为6.36,其预测SR的灵敏度为62.39%,特异度为77.12%。结论 NLR有助于预测IRA自发再通。

Objective To investigate the relationship between neutrophil to lymphocyte ratio and infarct related artery spontaneous recanalization in acute ST-segment elevation myocardial infarction. Methods From June 2013 to January 2017, retrospective study was performedon 471 patients with STEMI. Depending on the CAG, the patients were divided intoSR group and NSR group .Analyze the baseline clinical data and angiographic Characteristics of all patients. According to the results of coronary angiography, 117 cases were divided into spontaneous recanalization group and 354 cases without spontaneous recanalization group. The clinical data of the patients were analyzed. Results The proportion of antiplatelet drugs in group SR was higher than that in group NSR, while those ofNLR, HS- CRP, CTnl, CK-MB and LDL-C were lower than those in group NSR. Logistic regression analysis suggested that antiplatelet agents, HSCRP and NLR 〈 6.3 were independent predictors of SR, best ROC curve of coronary SR in patients with NLR was 6.36 STEM1, sensitivity of SR was 62.39% and specificity was 77.12%. Conclusion N LR helps predict spontaneous recanalization of IRA.