冠心病PCI术后非支架段血管病变进展与血小板的关系

Relationship between platelet and the progression of non-stent vascular lesions for coronary heart disease after PCI

目的探讨冠心病经皮冠状动脉介入治疗(PCI)后非支架段血管病变进展与血小板的关系。方法选取既往于郑州大学第一附属医院心血管内科接受PCI术治疗并于2017年1月至2018年1月再次入院复查冠状动脉造影(CAG)的314例冠心病患者。根据非支架段血管病变的变化将患者分为非进展组(188例)和进展组(126例)。根据Gensini评分标准将进展组患者分为A组(Gensini评分≤30分)75例、B组(Gensini评分>30且≤60分)32例、C组(Gensini评分>60分)19例。比较各组患者的血小板计数(PLT)、血小板压积(PCT)、平均血小板体积(MPV)、血小板分布宽度(PDW)。分析PDW、MPV水平与Gensini评分的相关性。结果进展组患者MPV、PDW水平均高于非进展组,差异有统计学意义(均P<0.05)。进展组和非进展组患者PLT、PCT水平比较,差异无统计学意义(P>0.05)。A组、B组和C组患者MPV和PDW水平均较非进展组高,差异有统计学意义(均P<0.05)。C组患者MPV和PDW水平均高于A组和B组,B组患者MPV和PDW水平高于A组,差异有统计学意义(均P<0.05)。进展组MPV、PDW水平均与Gensini积分呈正相关(r=0.283、0.314,P<0.05)。结论 MPV和PDW水平与冠心病PCI术后非支架段血管病变进展程度密切相关,有望成为冠心病PCI术后非支架段血管病变进展程度的预测因子。

Objective To explore the relationship between platelet and the progression of non-stent vascular lesions for coronary heart disease after percutaneous coronary intervention(PCI).Methods A total of 314 patients with coronary heart disease who were previously treated by PCI and readmitted for coronary angiography(CAG)in the Department of Cardiology of the First Affiliated Hospital of Zhengzhou University from January 2017 to January 2018 were selected.The patients were divided into non-progressive group(188 cases)and progressive group(126 cases)according to the changes of non-stent vascular lesions.According to Gensini scoring criteria,patients in progressive group were divided into group A(Gensini score was less than or equal to 30 points),group B(Gensini score was more than 30 points and less than or equal to 60 points),and group C(Gensini score was more than 60 points).There were 75 cases,32 cases and 19 cases in group A,group B and group C respectively.The platelet count(PLT),thrombocytocrit(PCT),mean platelet volume(MPV)and platelet distribution width(PDW)of patients in each group were compared.The correlations between the levels of PDW and MPV and Gensini score were analyzed respectively.Results The levels of MPV and PDW in progressive group were higher than those in non-progressive group,and the differences were statistically significant(both P<0.05).There were no significant differences in the levels of PLT and PCT between progressive group and non-progressive group(P>0.05).The levels of MPV and PDW in group A,group B and group C were higher than those in non-progressive group,and the differences were statistically significant(all P<0.05).The levels of MPV and PDW in group C were higher than those in group A and group B,while the levels of MPV and PDW in group B were higher than those in group A,and the differences were statistically significant(all P<0.05).The levels of MPV and PDW in progression group were positively correlated with Gensini integral(r=0.283,0.314,P<0.05).Conclusion The levels of MPV and PWD are closely related to the progression of non-stent vascular lesions in patients with coronary heart disease after PCI,and are expected to be the predictors of the progression of non-stent vascular lesions after PCI.