血小板分布宽度与急性心肌梗死患者严重程度及预后的相关性分析

Analysis of the correlation between PDW and severity and prognosis of patients with acute myocardial infarction

目的 探究血小板分布宽度（PDW）与急性心肌梗死（AMI）患者病情严重程度和预后的相关性.方法 选择2015-06～ 2016-06河南医学高等专科学校附属医院收治的AMI患者297例,根据患者就诊时的PDW水平,将其分为低PDW组（≤17％） 144例和高PDW组（＞17％）153例.比较两组患者的既往高血压、高血脂、糖尿病、心率、肌酐等基本资料,Killip分级,充血性心力衰竭、心源性休克、1年内病死率或再梗死发生率、住院期间病死率和1年内病死率.结果 高PDW组的患者吸烟史比例、KillipⅣ级患者比例、充血性心力衰竭、心源性休克、1年内病死或再梗死发生率、住院期间病死率明显高于低PDW组（x2=9.12、4.73、5.79、5.24、16.41、20.57;P＜0.05）;胸痛发生时间、KillipⅡ级患者比例明显低于低PDW组（t=7.28,x2=4.25;P＜0.05）.结论 PDW与AMI患者病情严重程度呈明显正相关,同时患者PDW上升,可能提示患者1年病死率和梗死再发生率较高,有助于指导临床治疗,改善患者的预后.

Objective To investigate the correlation between platelet distribution width （PDW） and severity and prognosis of patients with acute myocardial infarction （AMI）.Methods A total of 297 AMI patients were selected in our hospital from June 2015 to June 2016.According to the PDW level,they were divided into low PDW group （less than 17％） and high PDW group （PDW ＞ 17％）,with 144 cases and 153 cases,respectively.Comparing the two groups of patients with hypertension,hyperlipidemia,diabetes,heart rate,serum creatinine and other basic information,Killip classification,congestive heart failure,cardiogenic shock and death within 1 years or the incidence of re infarction,in-hospital mortality and mortality within 1 year.Results The high PDW group of the proportion of smoking history and grade Killip Ⅳ patients,congestive heart failure,cardiogenic shock,death or reinfarction within one year were higher than low PDW group （x2 =9.12,4.73,5.79,5.24,16.41,20.57;P ＜0.05）;the mortality rate during hospitalization was significantly higher than that in low PDW group （P ＜ 0.05）;the incidence of chest pain in Killip Ⅱ group was significantly lower than that in low PDW group （t =7.28,x2 =4.25;P ＜ 0.05）.Conclusion There is a significant positive correlation with AMI in patients with PDW disease severity,while patients with PDW increased,suggesting an increased risk of 1-year mortality and a higher incidence of re-infarction.Therefore,it helps to guide clinical treatment and improve the prognosis of patients with AMI.