平均血小板容积和Gensini积分对急性ST段抬高型心肌梗死患者PCI术后预后的影响

Values of MPV and Gensini on prognosis of patients with acute ST segment elevation myocardial infarction after PCI

目的观察平均血小板容积(MPV)、Gensini积分在预测急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后预后中的作用。方法回顾性收集2015年1月至于2016年1月接受PCI的STEMI患者303例,记录患者的一般资料、生化指标、MPV和Gensini积分;比较不同水平MPV患者的不良事件发生率;比较不同水平Gensini积分患者的不良事件发生率;比较主要不良心血管事件(MACE)组和无MACE组临床资料。采用Logistic回归分析STEMIPCI术后预后的独立危险因素。结果 MPV高水平组总不良事件率和再发心绞痛率、再次住院率高于低水平组,差异具有统计学意义(P<0.05);Gensini评分对急性ST段抬高型心肌梗死患者PCI术后预后无显著影响;MACE组阿司匹林、MPV、时间和支架长度高于无MACE,差异具有统计学意义(P<0.05);糖尿病、MPV、时间和高血压为STEMIPCI患者PCI术后预后的独立危险因素。结论 Gensini积分对STEMIPCI患者PCI术后预后无预测价值,MPV是STEMIPCI患者PCI术后预后的独立危险因素,可用于预测的预后情况。

Objective To investigate the prognostic value of MPV and Gensini in predicting the prognosis of patients with acute ST segment elevation myocardial infarction after PCI.Methods 303 patients with STEMI who underwent percutaneous coronary intervention in our hospital from January 2015 to January 2016 were collected.The general data,biochemical indicators,patients with MPV and Gensini score were recorded.The incidence of adverse events of patients with different level of MPV was compared,the incidence of adverse events of patients with different levels of Gensini integral was compared.The clinical data was compared between MACE group and non MACE group.Logistic regression analysis of prognosis after STEMIPCI was pereformed.Results The total adverse events rate and recurrence rate of angina pectoris in MPV group were significantly higher than those in low level group(P<0.05).Gensini score had no effect on the prognosis of patients with acute ST segment elevation myocardial infarction after PCI.Aspirin,MPV,time and stent length in MACE group were higher than those in non MACE group(P<0.05).Diabetes mellitus,MPV,time and hypertension were independent risk factors for the prognosis of postoperative PCI patients with STEMIPCI.Conclusion Gensini score has no predictive value for the prognosis of patients with PCI after STEMIPCI,and MPV is an independent prognostic factor for the prognosis of patients with STEMIPCI after PCI,which can be used to predict the prognosis.