血小板/淋巴细胞比值与急性心肌梗死近期和远期预后的相关性

Correlation of platelet/lymphocyte ratio with short-term and long-term prognosis in patients with acute myocardial infarction

选择2016年1月至2018年12月航天中心医院收治的95例急性心肌梗死患者,根据TIMI危险评分标准把患者分成高分组(46例,评分>4分)以及低分组(49例,评分≤4分),并根据血小板/淋巴细胞比值(PLR)分成低PLR组(60例,PLR<170)以及高PLR组(35例,PLR>170),分析PLR对急性心肌梗死的近期和远期预后的相关性。结果显示TIMI高分组和低分组的红细胞计数、血红蛋白、白细胞计数、中性粒细胞计数、中间细胞计数、淋巴细胞计数、嗜碱性粒细胞、红细胞分布宽度、嗜酸性粒细胞等血细胞参数差异无统计学意义(P>0.05),高分组的血小板计数和PLR明显高于低分组(t=42.196、10.053,P<0.05);高PLR组的院内死亡率和1年全因死亡率明显高于低PLR组[1.67%(1/60)比14.28%(5/35),χ^2=5.949,P=0.02;3.33%(2/60)比17.14%(6/35),χ^2=5.466,P=0.04],两组的1年心绞痛再住院率、介入治疗、溶栓治疗对比无统计学意义(P>0.05);Pearson相关性分析发现,PLR与TIMI评分呈正相关(r=0.563,P=0.024);logistic回归分析发现,Killip分级、血肌酐、PLR是急性心肌梗死的独立危险因素(OR=7.532、6.014、8.234,P<0.05)。提示PLR能有效评估急性心肌梗死者的近期和远期预后,应重视其临床应用价值。

Ninety-five patients with acute myocardial infarction(AMI)treated in our hospital from January 2015 to December 2017 were enrolled.According to thrombolysis in myocardial infarction(TIMI)risk score,95 patients were divided into high group(TIMI>4,n=46)and low group(TIMI≤4,n=49).According to platelet/lymphocyte ratio(PLR),95 patients were divided into low PLR group(PLR≤170,n=60)and high PLR group(PLR>170,n=35).The correlation of PLR with short-term and long-term prognosis in patients with acute myocardial infarction was analyzed.The results showed that there were no significant differences in red blood cell count(RBC),hemoglobin(HB),white blood cell count(WBC),neutrophil ratio(NEU),percentage of intermediate cells(MON),lymphocyte count(LYM),basophils(Bas),red blood cells distribution width(RDW),eosinophils(EO)between high and low TIMI groups(P>0.05).The platelet count(PLT)and PLR in high TIMI group was significantly higher than that in low TIMI group(t=42.196,10.053;P<0.05).The in-hospital mortality and all-cause mortality of high PLR group were significantly higher than those of low PLR group[1.67%(1/60)vs.14.28%(5/35),χ^2=5.949,P=0.02;3.33%(2/60)vs.17.14%(6/35),χ^2=5.466,P=0.04];while there was no significant difference in 1-year re-hospitalization rate,interventional therapy and thrombolytic therapy between the two groups(P>0.05).Pearson correlation analysis showed that PLR was positively correlated with TIMI score(r=0.563,P=0.024).Logistic regression analysis showed that Killip grade,serum creatinine and PLR were independent risk factors of AMI(OR=7.532,60.14,8.234;P<0.05).PLR may effectively evaluate the prognosis of acute myocardial infarction,suggesting that its clinical value should be condidered.