平均血小板体积/淋巴细胞比值与ST段抬高型心肌梗死患者梗死相关动脉自发再通的相关性研究

Correlation between mean platelet volume to lymphocyte ratio and spontaneous recanalization of infarct-related artery in patients with ST-segment elevation myocardial infarction

目的探讨平均血小板体积/淋巴细胞比值(MPVLR)与ST段抬高型心肌梗死(STEMI)患者梗死相关动脉(IRA)自发再通的相关性。方法回顾性分析2017年6月至2019年5月在嘉兴市第二医院确诊并在发病12h内行直接经皮冠状动脉介入手术(PPCI)的STEMI患者129例。根据冠状动脉造影结果分为自发再通组(22例)和非自发再通组(107例)。分析与IRA自发再通的相关因素及MPVLR预测IRA自发再通的价值。结果自发再通组患者MPVLR低于非自发再通组(P<0.01)。多因素logistic回归分析显示,MPVLR(OR=0.594,95%CI:0.434-0.813,P=0.001),hs-CRP(OR=0.751,95%CI:0.600-0.939,P=0.012),Hcy(OR=0.921,95%CI:0.863-0.984,P=0.015)与IRA自发再通呈独立负相关。ROC曲线显示,MPVLR预测IRA自发再通的曲线下面积(AUC)为0.752(95%CI:0.645-0.859,P<0.001)。结论MPVLR可能与STEMI患者IRA自发再通有关。

Objective To investigate the correlation between mean platelet volume to lymphocyte ratio(MPVLR)and infarct-related artery(IRA)spontaneous recanalization in patients with ST-segment elevation myocardial infarction(STEMI).Methods Clinical data of 129 STEMI patients underwent primary percutaneous coronary intervention(PPCI)within 12 hours from June 2017 to May2019 were retrospectively analyzed.They were divided into spontaneous recanalization group(22 cases)and non-spontaneous recanalization group(107 cases).The related factors of IRA spontaneous recanalization and the value of MPVLR in predicting spontaneous recanalization were analyzed.Results MPVLR was significantly lower in spontaneous recanalization group than in non-spontaneous recanalization group(P<0.01).Multivariate logistic regression analysis showed that MPVLR(OR=0.594,95%CI:0.434-0.813,P=0.001),high sensitivity C-reactive protein(hs-CRP)(OR=0.751,95%CI:0.600-0.939,P=0.012)and homocysteine(Hcy)(OR=0.921,95%CI:0.863-0.984,P=0.015)were independently and negatively correlated with spontaneous recanalization of IRA.The ROC curve showed that the area under the curve(AUC)of MPVLR predicting spontaneous recanalization of IRA was 0.752.Conclusion MPVLR may be related to spontaneous recanalization of IRA in patients with STEMI.