血小板形态参数与急性冠状动脉综合征患者冠状动脉病变严重程度的相关性

The correlation between platelet morphology parameters and the severity of coronary artery disease in patients with acute coronary syndrome

[目的]探讨血小板形态参数与急性冠状动脉综合征(ACS)患者冠状动脉病变程度的相关性。[方法]选择2019年1月—10月于南华大学附属第二医院心血管内科住院治疗的ACS患者121例,另选取于同期行选择性冠状动脉造影且结果正常者35例作为对照组,以平均血小板体积(MPV)、血小板分布宽度(PDW)、大血小板比率(PLCR)作为血小板形态参数指标。所有患者均行冠状动脉造影,根据结果统计Gensini评分,分为低分值组(1~40分)、中分值组(41~80分)、高分值组(81分及以上),比较各组之间血小板形态参数的差异,寻找Gensini高分的危险因素。[结果]ACS组MPV、PDW、PLCR及男性比例、肌酸激酶同工酶(CK-MB)、N末端脑钠肽前体(NT-proBNP)、尿酸(UA)、心肌肌钙蛋白I(cTnI)均显著高于对照组(P<0.05)。PDW、MPV、PLCR在对照组、Gensini低、中、高分值组中逐步递增(P<0.05)。Pearson相关分析显示,PDW(r=0.814,P<0.05)、MPV(r=0.822,P<0.05)、PLCR(r=0.802,P<0.05)与Gensini评分正相关。多元Logistic回归分析显示,PLCR可作为冠状动脉Gensini高分的危险因素。[结论]PLCR、PDW、MPV与ACS患者冠状动脉病变严重程度呈正相关,对冠状动脉病变严重程度的评估有潜在的重要意义。

Aim To explore the correlation between platelet morphology parameters and the severity of coronary artery disease in patients with acute coronary syndrome(ACS).Methods 121 ACS patients who were hospitalized in the Department of Cardiovascular Medicine of Second Affiliated Hospital of University of South China from January 2019 to October 2019 were selected,and 35 patients with normal results of selective coronary angiography during the same period were selected as the control group.Mean platelet volume(MPV),platelet distribution width(PDW),and platelet large cell ratio(PLCR)were used as platelet morphology parameters.All patients underwent coronary angiography and were divided into low score(1~40 points)group,medium score(41~80 points)group,and high score(81 points and above)group.The differences in platelet morphology parameters between each group were compared to identify risk factors for high Gensini scores.Results The MPV,PDW,PLCR,male proportion,creatine kinase isoenzyme(CK-MB),N-terminal-pro brain natriuretic peptide(NT-proBNP),uric acid(UA),and cardiac troponin I(cTnI)in the ACS group were significantly higher than those in the control group(P<0.05).PDW,MPV and PLCR gradually increased in the control group and Gensini low,medium,and high score groups(P<0.05).Pearson correlation analysis showed a positive correlation between PDW(r=0.814,P<0.05),MPV(r=0.822,P<0.05),PLCR(r=0.802,P<0.05)and Gensini score.Multiple Logistic regression analysis showed that PLCR can be a risk factor for high coronary Gensini score.Conclusion PLCR,PDW and MPV are positively correlated with the severity of coronary artery disease in patients with ACS,and have potential importance in evaluating the severity of coronary artery disease.