血小板平均体积在急性心肌梗死患者病情评估中的作用

Role of mean platelet volume in assessment of the severity in patients with acute myocardial infarction

目的观察血小板平均体积(mean platelet volume,MPV)在急性心肌梗死(acute myocardial infarction,AMI)患者病情评估中的作用。方法回顾性分析2014年1月至2016年7月华北理工大学附属医院心内科收治的AMI患者71例的临床资料,根据临床表现结合心电图表现、心肌酶学结果及冠状动脉造影结果,分为非ST段抬高型心肌梗死(non-ST-segment elevated myocardial infarction,NSTEMI)组、ST段抬高型心肌梗死(ST-segment elevated myocardial infarction,STEMI)组。另外,选取冠状动脉造影结果阴性的69例为对照组。收集研究对象的一般资料及实验室指标,计算全球急性冠状动脉事件注册(Global Registry of Acute CoronaryEvent,GRACE)评分以评估心肌梗死病情,分析MPV对AMI患者病情及预后的影响。结果 NSTEMI组及STEMI组男性患者比例、吸烟史患者比例、糖尿病史患者比例、血小板计数、MPV、血小板分布宽度(platelet distributionwidth,PDW)、血小板容积(hematocrit,PCT)、GRACE评分均高于对照组,差异有统计学意义(P<0.05)。MPV与GRACE评分呈正相关(r=0.364,P=0.000);PDW与GRACE评分呈正相关(r=0.186,P=0.027)。多元逐步回归分析结果显示,年龄、性别、MPV为影响GRACE评分的独立危险因素。结论 MPV在AMI的发生、发展中起一定作用,可作为评估心肌梗死病情及预后的一项参考指标。

Objectives To investigate the role of mean platelet volume(MPV)in assessment of the severity in patients with acute myocardial infarction(AMI).Methods Clinical characteristics of71patients with AMI from January2014to July2016in the Department of Cardiology of Affiliated Hospital of North China University of Science and Technology were retrospectively analyzed.According to clinical manifestations,electrocardiogram(ECG)findings,myocardial enzyme findings and coronary angiography results,the patients were divided into non-ST-segment elevated myocardial infarction(NSTEMI)group and ST-segment elevated myocardial infarction(STEMI)group.In addition,69patients with negative coronary angiography results were selected as control group.General information and laboratory indicators were collected.Global Registry of Acute Coronary Event(GRACE)score was calculated to assess myocardial infarction status.Effect of MPV on the severity and prognosis of patients with AMI was analyzed.Results In NSTEMI group and STEMI group,proportion of male patients,proportion of patients with smoking history and diabetes history,MPV,platelet count,platelet distribution width(PDW),hematocrit and GRACE scores were higher than those in control group,and the differences were statistically significant(P<0.05).MPV and GRACE score was positively correlated(r=0.364,P=0.000).PDW and GRACE score was positively correlated(r=0.186,P=0.027).Stepwise regression analysis showed that age,gender and MPV were independent risk factors of GRACE score.Conclusions MPV plays an important role in the occurrence and development of AMI,and can be used as an index to evaluate the condition and prognosis of myocardial infarction.