血小板分布宽度联合休克指数对急性心肌梗死患者长期预后的预测价值

Value of PDW combined with SI in predicting prognosis of patients with acute myocardial infarction

目的探究血小板分布宽度(platelet distribution width,PDW)联合休克指数(shock index,SI)对急性心肌梗死患者长期预后的预测价值。方法选取2011年3月-2013年3月于本院就诊的急性心肌梗死患者1 094例,随访5年,根据是否发生终点事件,分为预后良好组(G组,n=894)和预后不良组(P组,n=174),通过Cox回归分析急性心肌梗死患者长期预后的影响因素,分析SI和PDW及两者联合评估急性心肌梗死患者长期预后的敏感度和特异度。结果平均随访时间(47.35±8.57)个月,失访26例(2.38%)。COX回归结果显示PDW(HR:1.53;95%CI:1.193～1.962)和SI(HR:1.47;95%CI:1.089～1.984)均是影响AMI预后的独立危险因素;PDW联合SI对AMI预后评估的AUC显著高于SI和PDW(AUC,0.947 vs 0.863和0.765),敏感度为75.5%,特异度为100%。结论 PDW联合SI预测AMI预后的敏感度高,值得临床推广使用。

Objective To investigate the value of platelet distribution width(PDW) combined with shock index(SI) in predicting prognosis of acute myocardial infarction(AMI). Methods A total of 1 094 patients with acute myocardial infarction admitted to our hospital from March 2011 to March 2013 were followed up for ?ve years. According to the endpoint events, they were divided into good prognosis group(G group, n=894) and poor prognosis group(P group, n=174). The in?uencing factors of long-term prognosis of patients with acute myocardial infarction were explored by Cox regression. The sensitivity and speci?city of SI and PWD and their combination in assessing long-term prognosis were analyzed. Results The mean follow-up time was(47.35±8.57) months. Twentysix(2.38%) patients were lost to follow up. Cox regression showed that both PDW(HR, 1.53;95% CI, 1.193-1.962) and SI(HR,1.47;95% CI, 1.089-1.984) were independent predictors for the prognosis of AMI. The sensitivity and speci?city of PDW combined with SI in evaluating prognosis of AMI were 75.5% and 100%, and AUC was signi?cantly higher than that of SI and PDW(AUC,0.947 vs 0.863 and 0.765). Conclusion PDW combined with SI has high sensitivity in predicting the prognosis of AMI, which is worthy of clinical application.