平均血小板体积/血小板计数、血小板α颗粒膜糖蛋白对经皮冠状动脉介入治疗即刻血流分级及预后的预测价值

The value of mean platelet volume/platelet count and platelet α-granule membrane glycoprotein in predicting immediate blood flow grading and prognosis after percutaneous coronary intervention

目的 探讨平均血小板体积(MPV)/血小板计数(PC)、血小板α颗粒膜糖蛋白(CD62P)预测经皮冠状动脉介入治疗(PCI)即刻血流分级及预后的价值。方法 选取2018年5月至2020年2月河南省直属机关第一门诊部收治的41例PCI即刻心肌梗死溶栓治疗临床试验(TIMI)血流分级0~Ⅱ级病人(观察组)及41例PCI即刻TIMI血流分级Ⅲ级病人(对照组),比较两组及是否发生主要心血管不良事件(MACE)病人的MPV/PC、CD62P指标水平。以logistic回归方程进行多因素分析,采用受试者操作特征曲线(ROC)分析各指标对预测评估PCI即刻血流分级、预后的效能。结果 观察组MPV/PC 0.05±0.02、CD62P(52.26±14.47)%高于对照组的0.04±0.01、(38.87±12.76)%(P<0.05)。MPV/PC、CD62P仍是PCI即刻血流分级的独立相关危险因素(P<0.05);预测PCI即刻血流分级的ROC曲线下面积(AUC):MPV/PC为0.78,CD62P为0.81,MPV/PC+CD62P为0.86(P<0.05);MACE病人MPV/PC 0.06±0.02、CD62P(60.19±15.02)%高于无MACE者的0.05±0.01、(41.75±11.27)%(P<0.05);预测MACE的AUC:MPV/PC为0.76,CD62P为0.80,MPV/PC+CD62P为0.84(P<0.05)。结论 MPV/PC、CD62P均与PCI即刻TIMI血流分级有关,并能相互影响,两者联合具有较高的血流分级、MACE预测价值,有望成为预测PCI病人即刻血流分级和MACE的新方案。

Objective To investigate the value of mean platelet volume(MPV)/platelet count(PC) and platelet α-granule membrane glycoprotein(CD62P) in predicting immediate flow grading and prognosis of percutaneous coronary intervention(PCI).Methods From May 2018 to February 2020, 41 patients with immediate PCI thrombolysis for myocardial infarction(TIMI) blood flow grade 0-Ⅱ(observation group) and 41 patients with immediate PCI TIMI blood flow grade Ⅲ(control group) admitted to the First Outpatient Department of Henan Province were selected. The levels of MPV/PC and CD62P were compared between the two groups and in patients with or without major adverse cardiovascular events(MACE). Logistic regression equation was used for multivariate analysis, and receiver operating characteristic curve(ROC) was used to analyze the efficacy of each index in predicting the immediate blood flow grade and prognosis of PCI.Results MPV/PC 0.05±0.02 and CD62P(52.26±14.47)% in the observation group were higher than those in the control group 0.04±0.01 and(38.87±12.76)%(P<0.05). MPV/PC and CD62P were still independent risk factors for PCI immediate blood flow classification(P<0.05);The area under the ROC curve(AUC) for predicting PCI immediate blood flow grade: MPV/PC was 0.78,CD62P was 0.81, MPV/PC+CD62P was 0.86(P<0.05);The MPV/PC 0.06±0.02 and CD62P(60.19±15.02)% of patients with MACE were higher than those of patients without MACE 0.05±0.01 and(41.75±11.27)%(P<0.05);The predicted AUC of MACE: MPV/PC was 0.76, CD62P was 0.80, and MPV/PC+CD62P was 0.84(P<0.05).Conclusion MPV/PC and CD62P are both related to TIMI blood flow classification immediately after PCI, and can affect each other. The combination of the two has high blood flow classification and MACE prediction value, and it is expected to become a new scheme for predicting immediate blood flow classification and MACE in patients with PCI.