急性STEMI患者术前梗死相关动脉血流异常预测因素

Predictors of abnormal blood flow of infarct related artery in patients with acute ST-segment elevation myocardial infarction before PCI

目的探讨经皮冠状动脉介入(PCI)治疗的急性ST段抬高型心肌梗死(STEMI)患者术前梗死相关动脉血流异常的预测因素。方法连续选取2014年12月～2016年6月于西安市第五医院行PCI治疗的急性STEMI患者116例,根据冠脉造影及TIMI分级示血流有无异常分为试验组(血流异常)和对照组(血流无异常),试验组99例,对照组17例,观察记录患者的年龄、身高、体重、病程等基本信息,行彩超、心电图检查及生化检测,计算患者入院时中性粒细胞与淋巴细胞计数比值(NLR)。结果试验组患者淋巴细胞计数低于对照组,中性粒细胞计数、白细胞计数、中性粒细胞与淋巴细胞比值、空腹血糖、吸烟率高于对照组,差异具有统计学意义(P<0.05);对变量NLR、LVEL、白细胞计数、淋巴细胞计数、中性粒细胞计数、吸烟、空腹血糖进行多元Logistic回归分析,NLR和空腹血糖是PCI术前梗死相关动脉血流异常的独立危险因素,差异具有统计学意义(P<0.05)。结论 STEMI患者空腹血糖及中性粒细胞/淋巴细胞比值(NLR)可作为行患者术前梗死相关动脉血流是否正常的预测指标。

Objective To investigate the predictors of abnormal blood flow of infarct related artery in patients with acute ST-segment elevation myocardial infarction(STEMI)before percutaneous coronary intervention(PCI).Methods STEMI patients(n=116)undergone PCI were chosen from Xi'an Fifth Hospital from Dec.2014 to June 2016.The patients were divided,according to coronary angiography(CAG)results and TIMI grades,into test group(with abnormal blood flow,n=99)and control group(with normal blood flow,n=17).The basic information including age,height,weight and disease course were observed and recorded,and color Doppler ultrasound,electrocardiogram examination,blood biochemical detection were carried out in all patients.The neutrophil-to-lymphocyte ratio(NLR)was calculated in patients at time of hospitalization.Results Lymphocyte count was lower,and neutrophil count(NEUT),white blood cell count(WBC),NLR,fasting plasma glucose(FPG)and smoking rate were higher in test group than those in control group(P<0.05).The results of multi-factor Logistic regression analysis on NLR,LVEL,WBC,lymphocyte count,smoking and FPG showed that NLR and FPG were independent risk factors of abnormal blood flow of infarct related artery before PCI(P<0.05).Conclusion FPG and NLR can be taken as indexes for predicting abnormal blood flow of infarct related artery in STEMI patients before PCI.