不稳定型心绞痛患者PCI围术期心肌损伤与NLR、LMR、PLR相关性分析

Correlation between Myocardial Injury and NLR,LMR,PLR in Patients with Unstable Angina Pectoris during Perioperative Period of PCI

目的:探讨不稳定型心绞痛(UA)患者经皮冠脉介入治疗(PCI)围术期心肌损伤(PMI)与中性粒细胞计数与淋巴细胞计数比值(NLR)、淋巴细胞计数与单核细胞计数比值(LMR)、血小板计数与淋巴细胞计数比值(PLR)的相关性。方法:选取2017年1月至2020年6月就诊于我院心内科诊断为UA行PCI患者422例,分为PMI组和非PMI组,比较两组患者基本资料、NLR、LMR、PLR、drNLR、drLMR、drPLR、PCI相关指标以及Syntax评分,Pearson相关性分析探讨NLR、LMR、PLR、drNLR、drLMR、drPLR与hs-cTnT或cTnT的相关性,单因素及二元Logistic回归分析探讨UA行PCI的患者PMI发生的可能危险因素。结果:本研究共纳入422例患者,其中PMI组188例,非PMI组234例,PMI组患者NLR、PLR、drNLR、drLMR、drPLR、植入支架平均直径、植入支架平均长度、冠脉病变数、Syntax评分明显高于非PMI组,LMR明显低于非PMI组,差异有统计学意义(P<0.05);采用Pearson相关分析显示NLR、PLR、drNLR、drLMR、drPLR与hs-cTnT或cTnT呈正相关,LMR与hs-cTnT或cTnT呈负相关;单因素及二元logistic回归分析显示NLR、LMR、PLR、drNLR、drLMR、drPLR均为UA行PCI患者PMI发生的独立危险因素。结论:UA行PCI患者PMI的发生与机体全身炎症反应相关,PCI术后NLR、LMR、PLR以及三者PCI术前及术后变化程度均是UA行PCI患者PMI发生的独立危险因素。

Objective:To investigate the correlation between myocardial injury(PMI)and neutrophil count and lymphocyte count(NLR),lymphocyte count and monocyte count(LMR),platelet count and lymphocyte count(PLR)in patients with unstable angina pectoris during PCI..Methods:A total of 422 patients with PCI diagnosed as UA in cardiology department of our hospital from January 2017 to June 2020 were selected and divided into PMI group and non-PMI group.Basic data,NLR,LMR,PLR,DRNLR,DRLMR,DRPLR,PCI related indexes and SYNTAX score of the two groups were compared.Pearson correlation analysis was conducted to explore the correlation between NLR,LMR,PLR,DRNLR,DRLMR,DRPLR and hs-cTnT or cTnT.Univariate and binary Logistic regression analyses were conducted to explore the possible risk factors of PMI in patients with UA receiving PCI.Results:The study included 422 patients,Among them,188 cases in PMI group,234 cases in non PMI group,The mean diameter of NLR,PLR,drNLR,drLMR,drPLR,stent,the mean length of stent,the variables of coronary artery disease and the Syntax score were significantly higher in PMI group than in non-group,LMR significantly lower than the non PMI group,statistically significant(P<0.05);Using Pearson correlation analysis to show a positive correlation between NLR,PLR,drNLR,drLMR,drPLR and hs-cTnT or CTnT,LMR is negatively correlated with hs-cTnT or cTnT;Single factor and binary logistic regression analysis showed that NLR,LMR,PLR,drNLR,drLMR,drPLR were independent risk factors for PMI in patients with UA rows.Conclusion:The occurrence of PMI in UA patients after PCI is related to the body's systemic inflammatory response.NLR,PLR,LMR after PCI,as well as the degree of changes of the three before and after PCI are independent risk factors for PMI in UA patients undergoing PCI.