泛免疫炎症指数与急性ST段抬高型心肌梗死患者介入术后不良预后的关系

Expression of pan-immune inflammation value in patients with ST segment elevation myocardial infarction and its relationship with prognosis

目的:检测急性ST段抬高型心肌梗死(ST segment elevation myocardial infarction,STEMI)患者泛免疫炎症指数(pan-immune inflammation value, PIIV)与PCI后不良预后的关系。方法:选取常州市武进中医医院2018年1月至2020年3月连续收治的接受PCI的STEMI患者。根据PIIV的中位数(382.1)进行两等分组,分为低PIIV组(PIIV<382.1)和高PIIV组(PIIV≥382.1),收集两组患者的临床数据,分析PIIV与STEMI患者介入术后不良预后的关系。结果:与低PIIV组患者比较,高PIIV组患者的年龄和心率更高,血压更低,合并高血压病病史和2型糖尿病史的比例更大,发生MACE事件的比例也更高(P <0.05)。与低PIIV组患者比较,高PIIV组患者的WBC、中性粒细胞计数、单核细胞计数、PLT、hs-CRP、血糖、LVEF和肌酐含量更高,而淋巴细胞计数更低(P <0.05)。Kaplan-Meier分析显示,高PIIV组患者MACE的发生率明显高于低PIIV组(P <0.05)。ROC曲线结果表明,PIIV具有预测STEMI患者PCI术后MACE的价值,其AUC为0.881 (95%CI:0.832~0.952,P <0.05)。多因素Cox比例风险模型结果显示年龄、PIIV、中性粒细胞计数、淋巴细胞计数、PLT和LVEF是STEMI组患者PCI后MACE的影响因素(P <0.05)。结论:PIIV是STEMI患者PCI术后发生MACE的独立预测因子,并且具有良好的预测价值。

Objective:To observe the expression of pan-immune inflammation value(PIIV)in patients with ST segment elevation myocardial infarction(STEMI)and its relationship with prognosis.�Methods:A total of 272 patients with STEMI were selected and the patients were divided into the low PIIV group(<382.1)and the high PIIV group(≥�382.1)according to the median PIIV(382.1).The correlation between the expression level of PIIV and major adverse cardiovascular events(MACE)in patients with STEMI were analyzed.Results:Compared with patients in the low PIIV group,patients in the high PIIV group had a higher age and heart rate,lower blood pressure,a higher proportion of patients with hypertension history and type 2 diabetes history,and a higher proportion of MACE events(P<0.05).Compared with patients in the low PIIV group,patients in the high PIIV group had higher white blood cell count,neutrophil count,monocyte count,platelet count,hs CRP,blood glucose,LVEF,and creatinine levels,while lower lymphocyte count(P<0.05).Kaplan Meier analysis showed that the incidence of MACE events in patients with high PIIV was significantly higher than that in patients with low PIIV(P<0.05).The ROC curve results indicate that PIIV has the value of predicting MACE after PCI in STEMI patients,with an AUC of 0.881(95%CI:0.832-0.952,P<0.05).Conclusions:PIIV is an independent predictor of MACE in STEMI patients after PCI and has good predictive value.