ST段抬高心肌梗死患者入院时中性粒细胞计数与经皮冠状动脉介入治疗后血管造影无复流的关系

The relationship between neutrophil count and no-reflow phenomenon in patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention

目的探讨ST段抬高心肌梗死(STEMI)患者入院时中性粒细胞计数与经皮冠状动脉介入(PCI)治疗后血管造影无复流的关系。方法收集204例在症状出现后12 h内行PCI治疗的STEMI患者的临床资料,将患者分为无复流组(n=39)和正常复流组(n=165)。入院时测量中性粒细胞计数及其他血液学参数。采用多元Logistic回归分析确定无复流现象发生的独立预测因素。结果与正常复流组相比,无复流组患者的年龄较大〔(67.8±10.9)岁vs.(61.2±12.8)岁,P<0.05〕,且高敏C反应蛋白(hsCRP)水平(81.23 mg/L vs.35.82 mg/L)、肌钙蛋白(cTnI)峰值(65.47μg/L vs.33.69μg/L)和中性粒细胞计数(7.35×109/L vs.6.25×109/L)均较高(P<0.05)。在多变量分析中,年龄(OR=1.038,95%CI:1.008~1.064,P<0.05)和中性粒细胞计数(OR=1.236,95%CI:1.084~1.367,P<0.01)是无复流现象的独立预测因子。结论入院时中性粒细胞计数与PCI术后无复流的发生密切相关,其可用于STEMI患者无复流现象发生的风险评估,并可针对高危患者及时制定预防策略。

Objective To investigate the relationship between neutrophil count and no-reflow phenomenon in patients with ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods The clinical data of 204 patients with STEMI who underwent PCI within 12 h after the onset of symptoms were collected and divided into no-reflow group(n=39)and normal reflow group(n=165).Neutrophil counts and other hematological parameters were measured at admission.Multivariate Logistic regression analysis was used to determine independent predictors of no-reflow phenomenon.Results Compared with the normal reflow group,the age of the no-reflow group was significantly older\Conclusions The neutrophil count at admission is closely related to the occurrence of no-reflow after PCI.It can be used for risk assessment of no-reflow in STEMI patients,and timely prevention strategies can be developed for high-risk patients.