急性心肌梗死患者凝血及免疫炎症指标的变化观察

Observation on the Change of Coagulation and Immuno-inflammatory Indexes of Patients with Acute Myocardial Infarction

目的:探究及分析急性心肌梗死患者D-二聚体(D-D)、纤维蛋白原(FIB)、血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)及单核细胞与淋巴细胞比值(MLR)的变化。方法:选取武平县医院2020年6月-2022年2月收治的75例急性心肌梗死患者为A组,同时期的75例冠心病心绞痛患者为B组,75例无心肌梗死及心绞痛的糖尿病和/或高血压者为C组。检测及比较三组的凝血指标(D-D及FIB)及免疫炎症指标(PLR、NLR及MLR),并比较A组中不同GRACE评分者的检测结果,采用Spearman相关性分析D-D、FIB及PLR、NLR、MLR与GRACE评分的关系。结果:A组及B组的D-D、FIB及PLR、NLR、MLR均显著高于C组,且A组显著高于B组,差异有统计学意义(P<0.05)。A组中GRACE评分高危及中危者的D-D、FIB及PLR、NLR、MLR均显著高于低危者,且高危者的上述指标显著高于中危者,差异有统计学意义(P<0.05)。Spearman相关性分析显示,急性心肌梗死患者的D-D、FIB及PLR、NLR、MLR均与GRACE评分呈正相关(P<0.05)。结论:急性心肌梗死患者的D-D、FIB及PLR、NLR、MLR均相对更高,且与本病的危险程度密切相关,因此在急性心肌梗死患者中的检测价值较高。

Objective:To investigate and analyze the change of D-dimer(D-D),fibrinogen(FIB),platelet-to-lymphocyte ratio(PLR),neutrophil-to-lymphocyte ratio(NLR),monocyte-to-lymphocyte ratio(MLR)of patients with acute myocardial infarction.Method:A total of 75 patients with acute myocardial infarction from June 2020 to February 2022 were chosen as the group A,and 75 patients with angina pectoris of coronary heart disease at the same time were chosen as the group B,and 75 patients with diabetes and/or hypertension and without myocardial infarction and angina pectoris were chosen as the group C.Then the plasma coagulation indexes(D-D and FIB)and immuno-inflammatory indexes(PLR,NLR and MLR)of three groups were detected and compared,and the detection results of group A with different GRACE scores were compared too.The relationship between D-D,FIB,PLR,NLR,MLR and GRACE score were analyzed with Spearman correlation.Result:The D-D,FIB and PLR,NLR,MLR in group A and group B were significantly higher than those in group C,and the group A were significantly higher than those in group B,the differences were statistically significant(P<0.05).In group A,the D-D,FIB,PLR,NLR,MLR of high-risk and moderate risk persons with GRACE scores were significantly higher than those of low-risk persons,and the above indicators of high-risk persons were significantly higher than those of moderate risk persons,the differences were statistically significant(P<0.05).The Spearman correlation analysis showed that D-D,FIB,PLR,NLR and MLR were positively correlated with GRACE score of patients with acute myocardial infarction(P<0.05).Conclusion:The D-D,FIB and PLR,NLR,MLR of patients with acute myocardial infarction are relatively higher,and they are closely related to the risk of the disease,so their detection value in the patients with acute myocardial infarction are higher.