血小板/淋巴细胞计数比值对急性心肌梗死后发生心力衰竭的预测价值

Predictive value of platelet/lymphocyte count ratio in heart failure after acute myocardial infarction

目的 探讨血小板/淋巴细胞计数比值(PLR)对急性心肌梗死(AMI)后发生心力衰竭的预测价值.方法 回顾性分析2015年1月1日至2017年12月30日于神木市医院住院并行冠状动脉造影检查的232例AMI患者的临床资料.根据是否合并心力衰竭,分为心力衰竭组(n=164)和非心力衰竭组(n=68);同时,根据入院时血常规检测得到PLR值,再通过受试者工作特征曲线(ROC曲线)确定PLR的cut-off值,将其分为高PLR组(n=179)和低PLR组(n=53).比较心力衰竭组和非心力衰竭组患者的基线资料、实验室资料、冠状动脉造影资料;比较高PLR组和低PLR组不良心血管事件发生情况.对AMI患者发生心力衰竭的影响因素进行分析.结果 ROC曲线分析显示,PLR预测AMI患者发生心力衰竭的cut-off值为169.7,灵敏度和特异度分别为52.1% 和89.9%.单因素分析发现,淋巴细胞计数、中性粒细胞计数/淋巴细胞计数比值(N L R)、PLR、N端脑利钠肽是AMI患者发生心力衰竭的危险因素(P<0.05).多因素Logistic回归分析发现,PLR(OR:1.037,95%CI:1.021~1.054,P<0.001)、N端脑利钠肽(OR:1.001,95%CI:1.001~1.002,P<0.001)是AMI患者发生心力衰竭的独立预测因子.结论 PLR与AMI后心力衰竭相关,PLR越高,AMI后心力衰竭发生率越高,且PLR与N端脑利钠肽是AMI患者发生心力衰竭的独立预测因子.

Objective To explore the predictive value of platelet/lymphocyte ratio (PLR) in heart failure after acute myocardial infarction (AMI). Methods A total of232 patients with AMI from January1,2017 to December30,2018 were retrospectively analyzed.According to whether or not heart failure occurred,they were divided into heart failure group ( n =164) and non-heart failure group ( n =68).At the same time,according to the PLR value obtained by routine blood test at admission,the cut-off point of PLR was determined by ROC curve,and the patients were divided into high PLR group ( n =179) and low PLR group ( n =53).The baseline data,laboratory data and coronary angiographic data of patients with heart failure group and non-heart failure group were statistically analyzed,and the rates of high PLR group and low PLR group were compared.Influenced factors of incidence of heart failure in AMI patients were also analyzed. Results ROC curve analysis showed that the cut-off point of PLR was169.7,and the corresponding sensitivity and specificity were 52.1% and 89.9%.Single factor analysis showed that lymphocyte count,neutrophil /lymphocyte rate (NLR),PLR and N-terminal brain natriuretic peptide were risk factors for heart failure after the AMI ( P<0.05 ).Multivariate Logistic regression analysis showed that PLR ( OR :1.037,95% CI :1.021-1.054, P<0.001 ) and N-terminal brain natriuretic peptide ( OR :1.001,95% CI :1.001-1.002, P<0.001)were independent predictors of heart failure after AMI patients. Conclusion PLR is associated with heart failure after AMI.The higher the PLR value,the higher the incidence of heart failure after AMI.PLR and N-terminal brain natriuretic peptide are independent predictors of heart failure after AMI.