急性STEMI患者MPV与住院期间不良事件的关系

Relationship Between the Mean Olatelet Volume of Patients With Acute ST-segment Elevation Myocardial Infarction and Adverse Events During Hospitalization

目的探讨平均血小板体积(MPV)与行PCI术的急性ST段抬高型心肌梗死(STEMI)患者住院期间主要心脏不良事件的关系。方法选择2018年1月—2019年6月本院行PCI术且资料完整的STEMI患者共253例,根据有无MACE事件分为非MACE组196例和MACE组57例。比较两组患者的一般资料和实验室指标,采用多因素logistic回归分析MACE的预测因素,绘制受试者工作特征曲线(ROC曲线)评价MPV对住院期间MACE的预测价值。根据ROC曲线的截断点将患者分为高MPV组176例及低MPV组77例,比较两组间MACE的发生率。结果(1)两组间性别、高血压、糖尿病、血肌酐、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血小板计数、血红蛋白和白细胞计数差异无统计学意义(P>0.05);NT-proBNP、高敏肌钙蛋白、MPV、红细胞分布宽度和左室射血分数(LVEF)比较差异均有统计学意义(P<0.05)。(2)多因素logistic回归分析显示LVEF[OR=0.001,95%CI(0.000-0.114)]和MPV[OR=1.403,95%CI(1.053-1.869)]是住院期间不良事件的独立预测因素。(3)ROC曲线显示,MPV预测住院期间MACE事件的曲线下面积为0.642[95%CI(0.562-0.722)],最佳截断值为10.25,灵敏度为86.0%,特异度为36.2%。(4)高MPV组住院期间MACE发生率明显高于低MPV组(P<0.05)。结论MPV是行PCI术的急性STEMI患者住院期间不良事件的独立预测因素。

Objective To investigate the relationship between mean platelet volume(MPV)and major adverse cardiac events(MACE)during hospitalization in acute STsegment elevation myocardial infarction(STEMI)patients who underwent percutaneous coronary intervention(PCI).Methods Totally 253 patients with acute STEMI treated with PCI from January 2018 to June 2019 were selected as objects.According to the presence or absence of MACE,patients were divided into non-MACE group(196 cases)and in MACE group(57 cases).Compare the general information and laboratory indicators of the two groups of patients.Multi-factor logistic regression was used to analyze the predictive factors of MACE,and the receiver operating characteristic curve(ROC curve)was drawn to evaluate the predictive value of MPV to MACE during hospitalization.According to the cut-off point of the ROC curve,the patients were divided into high MPV group(176 cases)and low MPV group(77 cases),and the incidence of MACE was compared between the two groups.Results(1)There were no significant differences in gender,hypertension,diabetes,blood creatinine(Cr),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),platelet count(PLT),hemoglobin(Hb),and white blood cell count(WBC)between the two groups(P>0.05).NT-proBNP,high-sensitivity troponin(HscTnT),MPV,red blood cell distribution width(RDW)and left ventricular ejection fraction(LVEF)were statistically significant(P<0.05).(2)Multivariate logistic regression analysis showed that LVEF[OR=0.001,95%CI(0.000-0.114)]and MPV[OR=1.403,95%CI(1.053-1.869)]were independent predictors of MACE during hospitalization.(3)ROC curve shows that MPV predicts the area under the curve of MACE events during hospitalization is 0.642[95%CI(0.562-0.722)],the best cutoff value is 10.25,the sensitivity is 86.0%,and the specificity is 36.2%.(4)The incidence of MACE during hospitalization in the high MPV group was significantly higher than that in the low MPV group(P<0.05).Conclusion MPV is an independent predictor of adverse events during hospitalization of acute STEMI patients undergoing PCI.