血小板与淋巴细胞比值和中性粒细胞与淋巴细胞比值与急性冠脉综合征患者经皮冠脉介入术后短期预后的相关性分析

Correlation Between Platelet/Lymphocyte Ratio and Neutrophil/Lymphocyte Ratio and Short-Term Prognosis After Percutaneous Coronary Interventionin in Patients with Acute Coronary Syndrome

目的探讨急性冠脉综合征(ACS)患者行经皮冠脉介入术(PCI)前外周血中血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)和术后短期主要心血管不良事件(MACE)的关系。方法回顾性分析郑州大学第一附属医院508例行PCI术的ACS患者(ACS组),以同时段129例健康体检人群为对照组。收集临床资料,并且术后随访6个月,统计ACS患者PCI术后MACE发生情况。单因素和多因素logistic回归模型分析影响ACS患者PCI术后MACE的危险因素。受试者工作特征曲线(ROC)分析PLR、NLR对ACS以及MACE事件的预测价值。结果ACS组血肌酐、血小板、中性粒细胞、PLR、NLR高于对照组(P<0.05),而高密度脂蛋白、淋巴细胞、LVEF均低于对照组(P<0.05)。ROC结果显示,PLR、NLR以及联合预测ACS的曲线下面积(AUC)分别为0.776、0.822、0.886。多因素logistic回归分析显示,PLR、NLR均是影响ACS患者PCI术后发生MACE事件的独立危险因素(P<0.05)。PLR、NLR单独预测发生MACE的AUC为0.781、0.723,二者联合预测的AUC为0.849。结论PLR和NLR在ACS患者外周血中显著升高,并对ACS有一定预测价值;PLR、NLR是影响ACS患者PCI术后短期MACE的独立危险因素,PLR联合NLR对ACS患者PCI术后短期MACE事件的发生有预测价值。

Objective To investigate the relationship between platelet to lymphocyte ratio(PLR)and neutrophil to lymphocyte ratio(NLR)in peripheral blood of patients with acute coronary syndrome(ACS)before percutaneous coronary intervention(PCI)and short-term adverse cardiovascular events(MACE)after PCI.Methods A total of 508 ACS patients who underwent PCI in the First Affiliated Hospital of Zhengzhou University(ACS group)were retrospectively analyzed,and 129 healthy people who underwent physical examination at the same period were taken as the control group.The clinical data were collected,and the occurrence of MACE events was counted during the 6-months follow-up after PCI in patients with ACS.Univariate and multivariate logistic regression models were used to analyze the risk factors for MACE events in ACS patients after PCI.Receiver operating characteristic curve(ROC)curve was used to analyze of the predictive value of PLR and NLR for ACS and MACE events.Results The serum creatinine,platelets,neutrophils,PLR and NLR in the ACS group were significantly higher than those in the control group(P<0.05),while high-density lipoprotein,lymphocytes and LVEF were significantly lower than those in the control group(P<0.05).The ROC results showed that the area under the curve(AUC)of PLR,NLR and joint prediction of ACS were 0.776,0.822,and 0.886,respectively.Multivariate logistic regression analysis showed that both PLR and NLR were independent risk factors for MACE events in ACS patients after PCI(P<0.05).The AUC of PLR and NLR alone for predicting MACE in ACS patients were 0.781 and 0.723,and the AUC for their combined prediction was 0.849.Conclusion PLR and NLR are significantly increased in peripheral blood of ACS patients,and have certain predictive value for ACS.PLR and NLR are independent risk factors for short-term MACE in ACS patients after PCI,and PLR combined with NLR has predictive value for short-term MACE events in ACS patients after PCI.