血小板体积分布宽度与老年人急性冠状动脉综合征病变程度的相关性

Correlation between platelet volume distribution width and coronary artery lesion in elderly patients with acute coronary syndrome

目的探讨血小板体积分布宽度(PDW)与60岁以上急性冠状动脉综合征(ACS)患者冠状动脉病变程度的关系。方法回顾性分析心内科诊断为ACS的60岁及以上老年患者330例[年龄(66±6)岁]和行冠状动脉造影无冠状动脉病变的对照人群110例[年龄(66±6)岁]。经冠状动脉造影检查分为对照组(冠状动脉造影正常组) 110例,A组(冠状动脉单支病变组) 126例、B组(双支病变组) 116例和C组(多支病变组) 88例。比较分析4组的血小板参数及血脂水平等实验室指标并将其与冠状动脉病变程度进行相关性分析;采用受试者工作特征曲线分析PDW对ACS的界定值。结果与对照组比较,A组、B组和C组PDW增高(P <0. 001),血小板计数(PC)下降(P <0. 001),PC与PDW比值降低(P <0. 001),高密度脂蛋白胆固醇(HDL-C)降低(P <0. 001),差异有统计学意义。PDW与冠状动脉病变程度呈正相关(r=0. 618,P <0. 001)。受试者工作曲线分析结果显示,当以PDW的检测截点> 14. 9%作为ACS的诊断点,PDW诊断ACS的敏感度和特异度分别为92. 7%和95. 5%(曲线下面积AUC=0. 979,95%CI:0. 967~0. 990,P <0. 01)。结论PDW与老年患者ACS冠状动脉病变程度具有相关性,对ACS的早期诊断具有较好的临床价值。

Objective To investigate the correlation between platelet volume distribution width（ PDW） and coronary artery lesion in elderly patients with acute coronary syndrome（ ACS）. Methods A retrospective analysis was conducted on 330 patients with ACS and 110 health subjects（ control group）,who were admitted to cardiology department of Heping Hospital Affiliated to Changzhi Medical College from April 2016 to July 2017. All subjects were divided into 4 groups,control group（ n=110）,single branch coronary lesion group（ Group A group,n = 126）,double branches coronary lesion group（ Group B,n = 116） and multiple branches coronary lesion group（ Group C,n = 88）. Baseline data were compared among the four groups,and the correlation between PDW and the degrees of coronary lesion was analyzed.Furthermore,receiver operating characteristic curve（ ROC） analysis was performed to determine the value of PDW for diagnosing ACS. Results Baseline PDWs were significantly higher in Group A,B and C compared with control group（ F = 254. 806,P 〈0. 001）. There was a significantly positive correlation between PDW and coronary lesion（ r = 0. 618,P 〈0. 001）. When the PDW 〉14. 9% was conducted as threshold,the sensitivity and specificity of PDW diagnosing ACS were 92. 7% and 95. 5%,respectively（ AUCROC= 0. 979,95% CI; 0. 967-0. 990,P〈 0. 01）. Conclusions There is a good correlation between PDW and coronary artery lesion in elderly ACS patients.