PLR与急性冠状动脉综合征病变严重程度及预后关系的Meta分析

RELATIONSHIP BETWEEN PLATELET-TO-LYMPHOCYTE RATIO AND THE SEVERITY AND PROGNOSIS OF ACUTE CORONARY SYNDROME:A META-ANALYSIS

目的通过Meta分析的方法,探讨血小板/淋巴细胞比值(PLR)与急性冠状动脉综合征(ACS)病变严重程度及预后之间的关系。方法以“急性冠状动脉综合征”、“血小板/淋巴细胞比值”、“acute coronary syndrome”、“platelet-to-lymphocyte ratio”等为关键词,检索PubMed、Cochrane Library、中国知网等数据库建库至2019年7月公开发表的相关中英文文献。经筛选文献、质量评估、提取资料后进行Meta分析,探讨PLR与ACS的相关性。结果共纳入16项研究15016例ACS病人。应用SYNTAX评分系统将病人分为病变严重组及病变非严重组,Meta分析显示,病变严重组的PLR明显高于非严重组,差异有统计学意义(P=0.003)。关于PLR与ACS预后关系的Meta分析显示,PLR高的病人住院期间发生死亡事件(风险比(RR)=2.26,P<0.01)及主要不良心血管事件(MACE)(RR=2.33,P<0.01)的风险明显高于PLR低的病人;长期随访显示,PLR高的病人发生死亡事件(RR=2.14,P<0.01)及MACE(RR=1.68,P<0.01)的风险也明显高于PLR低的病人。结论PLR较高的ACS病人病变较严重,预后较差,PLR值对临床ACS病变严重程度及预后判断有一定的参考价值。

Objective To explore the relationship between platelet-to-lymphocyte ratio(PLR)and the severity and prognosis of acute coronary syndrome(ACS)by a Meta-analysis.Methods Databases such as PubMed,the Cochrane Library,and CNKI were searched for relevant Chinese or English articles published up to July 2019 with the Chinese or English key words of“acute coronary syndrome”and“platelet-to-lymphocyte ratio”.After screening the literature,assessing literature’s quality,and extracting the data,the Meta-analysis was performed to identify the relationship between PLR and ACS.Results A total of 16 studies were included,involving 15016 ACS patients.The patients were divided into severe group and non-severe group by the SYNTAX score.The Meta-analysis showed that PLR in the severe group was significantly higher than that in the non-severe group(P=0.003).The patients with high PLR had significantly higher risks of mortalities(risk ratio(RR)=2.26,P<0.01)and major adverse cardiovascular events(MACE)(RR=2.33,P<0.01)during hospitalization than those with low PLR.In long-term follow-up,the risks of mortalities(RR=2.14,P<0.01)and MACE(RR=1.68,P<0.01)were also significantly higher in the patients with high PLR than in those with low PLR.Conclusion ACS patients with high PLR have more serious lesions and a worse prognosis.PLR may be an indicator for the severity and prognosis of ACS.