血小板聚集率及血小板平均体积预测ACS支架术后在院期间心血管事件的价值

The predictive value of platelet aggregation rate and mean platelet volume for the in-hospital cardiovascular events in ACS patients after stenting

目的:评价血小板聚集率(platelet aggregation rate,PAR)血小板平均体积(mean platelet volume,MPV)对ACS支架术后在院期间不良心血管事件(major adverse cardiovascular events,MACE)的预测价值。方法:连续性招募2019年1月~2019年12月在我院行PCI术的106例ACS患者,根据患者PCI术后在院治疗期间是否发生MACE将患者分为MACE组(n=21)及非MACE组(n=85),检测所有患者外周血MPV及PAR水平。分析MPV及PAR与MACE关系,采用受试者工作特征曲线(ROC)法评价两者作为MACE预测指标的价值,同时应用二元logistic回归分析MPV及PAR与MACE的关系。结果:与非MACE组比较,MACE组患者MPV((10.51±1.21)fl 和(13.14±1.73)fl)和PAR((42.45±7.32)% 和(55.49±7.21)%)水平较高,同时MPV和PAR可作为预测ACS支架术后在院期间心血管事件的指标,其曲线下面积(AUC)(95%CI)分别为0.88(0.81~0.95)和0.85(0.76~0.93),其最佳诊断界值为11.53fl和50.67%,同时MPV>11.53fl及PAR>50.67%是发生MACE的独立危险因素,其优势比(OR)(95%)分别为9.35(3.10~28.20)和13.45(5.03~35.94)。结论:ACS患者就诊时的MPV与PAR可以作为预测其支架术后在院期间发生心血管事件的指标,同时MPV>11.53fl和PAR>50.67%是ACS患者支架术后在院期间心血管事件的独立危险因素。

Objective To evaluate the predictive value of platelet aggregation rate (platelet aggregation rate,PAR) and mean platelet volume (MPV) for adverse cardiovascular events (MACE) during hospitalization after ACS stenting.Methods 106 patients with ACS undergoing PCI in our hospital were collected continuously from January 2019 to December 2019,all subjects were divided into MACE group (n=21) and non-MACE group (n=85) according to whether MACE occurred in-hospital after PCI,and all of them were detected levels of MPV and PAR.We analyzed the relationship between MPV and PAR and MACE,to evaluate the value of them for predicting MACE by using receiver operating characteristic curve and logistic regression analysis.Results Compared with non-MACE group,it has a higher level of MPV ((10.51±1.21) fl and (13.14±1.73) fl) and PAR ((42.45±7.32) % and (55.49±7.21) %) in MACE group.The area under curve (AUC) of MPV and PAR for in-hospital MACE were 0.88(0.81~0.95) and 0.85(0.76~0.93),respectively,at the same time,MPV>11.53fl and PAR>50.67% were independent risk factors for MACE their odds ratio (OR) (95%) were 9.35(3.10~28.20) and 13.45(5.03~35.94),respectively.Conclusion The MPV and PAR in ACS patients severed as predictors of MACE during hospitalization after stenting,MPV>11.53fl and PAR>50.67% were independent risks factor of MACE during ACS patients in the hospital after stenting.