急性冠状动脉综合征患者经皮冠状动脉介入术后平均血小板容积对近期预后的影响

Effect of mean platelet volume on short-term prognosis in patients with acute coronary syndrome after percutaneous coronary intervention

目的研究急性冠状动脉综合征(ACS)患者平均血小板容积(MPV)对经皮冠状动脉介入术(PCI)术后近期预后的影响。方法选择2015年3月至2018年3月期间在信阳市中心医院行PCI的100例ACS患者作为研究对象,根据PCI术后1年内是否发生不良心血管事件分为预后不良组及对照组。分析2组间一般临床资料、实验室指标、超声指标、PCI治疗情况的差异,采用COX模型分析预后的影响因素,采用ROC曲线分析MPV对预后的预测价值。结果预后不良组的高血压率、糖尿病率、吸烟率、MPV、C反应蛋白(CRP)、低密度脂蛋白胆固醇均高于对照组,使用血栓抽吸、替罗非班的比例低于对照组(P<0.05)。经COX回归分析,吸烟、MPV升高、CRP升高是预后不良的独立危险因素(P<0.05)。经ROC曲线分析,MPV对ACS患者PCI术后1年内发生不良心血管事件具有较好的预测价值,最佳截点为10.68 fL,预测的敏感度为70.73%,特异度为72.22%。Kaplan-Meier曲线分析显示,MPV增加的ACS患者不良心血管事件的发生率高于MPV正常的ACS患者(P<0.05)。结论MPV升高是ACS患者PCI术后1年内发生不良心血管事件的独立危险因素,MPV超过10.68 fL对不良心血管事件具有较好的预测价值。

Aim To study the effect of mean platelet volume(MPV)on the short-term prognosis of patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods 100 patients with ACS who underwent PCI in Xinyang Central Hospital from March 2015 to March 2018 were selected as the study subjects.According to whether adverse cardiovascular events occurred within one year after PCI,the patients were divided into two groups:the poor prognosis group and the control group.Then the differences of general clinical data,laboratory indexes,ultrasound indexes and PCI treatment between the two groups were analyzed.The influencing factors of prognosis were analyzed by COX model,and the predictive value of MPV on prognosis was analyzed by ROC curve.Results The rates of hypertension,diabetes mellitus,smoking and MPV,C-reactive protein(CRP)and low density lipoprotein cholesterol in the poor prognosis group were higher than those in the control group,and the proportions of thrombus aspiration and tirofiban use were lower than those in the control group(P<0.05).COX regression analysis showed that smoking,elevated MPV and CRP were independent risk factors for poor prognosis(P<0.05).By ROC curve analysis,MPV had a good predictive value for adverse cardiovascular events in ACS patients within one year after PCI,and the best cutoff point was 10.68 fL,the sensitivity of prediction was 70.73%,and the specificity was 72.22%.Kaplan-Meier curve analysis showed that the incidence of adverse cardiovascular events in ACS patients with increased MPV was higher than that in ACS patients with normal MPV(P<0.05).Conclusions The increase of MPV is an independent risk factor for adverse cardiovascular events in ACS patients within one year after PCI.The MPV of more than 10.68 fL has a good predictive value for adverse cardiovascular events.