白细胞/平均血小板体积比值(WMR)、纤维蛋白原/白蛋白比值(FAR)在预测急性ST段抬高型心肌梗死预后临床价值

Clinical value of white blood cell to mean platelet volume ratio(WMR)and fibrinogen to albumin ratio (FAR) on predicting the prognosis of acute ST-segment elevation myocardial infarction

目的:分析白细胞/平均血小板体积比值(WMR)、纤维蛋白原/白蛋白比值(FAR)在预测急性ST段抬高型心肌梗死(STEMI)患者预后的临床价值。方法:回顾性分析2017年3月~2020年3月于我院行急诊冠状动脉介入治疗(PCI)的82例急性STEMI患者临床资料。根据患者入院时冠状动脉狭窄程度积分(Gensini积分)水平分为低分组(Gensini积分<42,n=35)、中分组(42≤Gensini积分<64,n=29)、高分组(Gensini积分≥64,n=18),比较三亚组患者术前WMR、FAR水平;采用Spearman等级相关系数分析急性STEMI患者术前WMR、FAR水平与冠状动脉狭窄程度的相关性。根据患者术后1年半内心血管事件发生情况将其分为有事件组(n=31)和无事件组(n=51),比较两亚组患者术前WMR、FAR水平及Gensini积分差异;经ROC曲线评估术前WMR、FAR、Gensini积分在急性STEMI患者术后1年半内心血管事件发生情况预测中的效能。结果:低分组患者WMR、FAR显著高于高分组,中分组患者FAR显著高于高分组。经Spearman等级相关系数分析显示,Gensini积分与WMR、FAR呈正相关性。无事件组患者WMR、FAR与Gensini积分显著低于有事件组。经ROC曲线评估显示,术前WMR、FAR水平及Gensini积分预测急性STEMI患者术后1年半内心血管事件发生情况的曲线下面积(AUC)分别为0.674、0.861和0.755,诊断临界值分别为1554.50(×10^(-6)/L^(2))、1.38和68.73分;WMR与FAR联合预测的AUC为0.924。结论:术前WMR、FAR检测有助于预测急性STEMI患者的预后情况,且联合检测的预测效能更高,对帮助调节患者预后状态有利。

Objective To analyze the clinical value of white blood cell to mean platelet volume ratio (WMR) and fibrinogen to albumin ratio (FAR) on predicting the prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI).Methods The clinical data of 82 patients with acute STEMI who underwent emergency percutaneous coronary intervention (PCI) in the hospital between March 2017 and March 2020 were retrospectively analyzed.According to the coronary artery stenosis degree (Gensini score) at admission,the patients were divided into low point group (Gensini score<42,n=35),middle point group (42≤Gensini score<64,n=29) and high group (Gensini score≥ 64,n=18).The preoperative WMR and FAR levels of patients were compared among the three subgroups.Spearman rank correlation coefficient was used to analyze the correlation between the preoperative WMR and FAR levels and degree of coronary artery stenosis in patients with acute STEMI.Patients were classified as event group (n=31) and non-event group (n=51) according to the occurrence of cardiovascular events within one and a half years after surgery.Differences in preoperative WMR and FAR levels and Gensini score of patients were compared between the two subgroups.ROC curve was used to evaluate the efficiency of preoperative WMR,FAR and Gensini score on predicting the occurrence of cardiovascular events in patients with acute STEMI within one and a half years after surgery.Results The WMR and FAR of low point group were significantly higher than those of high point group,and the FAR of middle point group was significantly higher than that of high point group.Spearman rank correlation coefficient analysis showed that Gensini score was positively correlated with WMR and FAR.The WMR,FAR and Gensini score of patients in non-event group were significantly lower than those in event group.ROC curve evaluation showed that the areas under the curves (AUC) of preoperative WMR,FAR and Gensini score in predicting the occurrence of cardiovascular events in patients with acute STEMI within one and a half years after surgery were 0.674,0.861 and 0.755 respectively and the diagnostic cut-off values were 1554.50(×10^(-6)/L^(2)),1.38 and 68.73 points,and the AUC of WMR combined with FAR was 0.924.Conclusion Preoperative WMR and FAR detection can help predict the prognosis of patients with acute STEMI,and the combined detection has higher predictive efficiency and is beneficial to helping adjust the prognosis status of patients.