AMI患者PLT、PDW、PLR水平及其与疾病严重程度的相关性研究

Analysis of PLT,PDW,PLR levels and their correlation with disease severity in patients with AMI

目的探讨急性心肌梗死(AMI)患者血小板计数(PLT)、血小板分布宽度(PDW)、血小板/淋巴细胞比值(PLR)水平及其与疾病严重程度的相关性。方法选取2017年1月至2020年12月苏州市相城区中医医院收治的200例AMI患者作为观察组,另选取同期150例常规体检健康者作为对照组。根据AMI患者随访结果又分为预后不良组和预后良好组。比较观察组和对照组,以及预后良好组和预后不良组PLT、PDW、PLR水平。采用多因素Logistic回归分析AMI患者预后的危险因素。采用Spearman相关分析Killip心功能分级与PLT、PDW、PLR水平的相关性;采用Pearson相关分析PLT、PDW、PLR水平的相关性。结果观察组PLT[(166.32±28.44)×10^(9)/L]高于对照组[(158.77±30.52)×10^(9)/L],PDW[(16.59±4.95)%]高于对照组[(15.54±3.01)%],PLR(162.40±78.85)高于对照组(114.74±12.34),差异均有统计学意义(P<0.05)。预后不良组和预后良好组性别、年龄、体质量指数、吸烟史、糖尿病、高血压、高血脂比较,差异均无统计学意义(P>0.05);预后不良组和预后良好组Killip心功能分级,PLT、PDW、PLR水平比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,PLT、PDW、PLR水平升高是AMI患者预后不良的独立危险因素(P<0.05)。Spearman相关分析结果显示,Killip心功能分级与PLT、PDW、PLR水平均呈正相关(r=0.702、0.664、0.302,P<0.05);Pearson相关分析结果显示,PLT水平与PDW、PLR水平均呈正相关(r=0.361、0.507,P<0.05),PDW水平与PLR水平呈正相关(r=0.596,P<0.05)。结论AMI患者PLT、PDW、PLR水平均升高,并且与AMI患者的Killip心功能分级均呈正相关,PLT、PDW、PLR可作为预测AMI患者预后的良好指标,对预防和治疗AMI有重要临床意义。

Objective To investigate the levels of platelet count(PLT),platelet distribution width(PDW)and platelet/lymphocyte ratio(PLR)in patients with acute myocardial infarction(AMI)and their correlation with disease severity.Methods A total of 200 AMI patients admitted to Suzhou Xiangcheng Hospital of Traditional Chinese Medicine from January 2017 to December 2020 were selected as the observation group,and 150 healthy people who underwent routine physical examination during the same period were selected as the control group.According to the follow-up results,AMI patients were divided into poor prognosis group and good prognosis group.The PLT,PDW and PLR levels of the good prognosis group and the poor prognosis group were compared between the observation group and the control group.Multivariate Logistic regression was used to analyze the risk factors of prognosis in patients with AMI.Spearman correlation analysis was used to analyze the correlation between Killip classification and PLT,PDW,PLR levels.Pearson correlation analysis was used to analyze the correlation between PLT,PDW and PLR levels.Results The platelet count in the observation group[(166.32±28.44)×10^(9)/L]was higher than that in the control group[(158.77±30.52)×10^(9)/L],PDW in the observation group[(16.59±4.95)%]was higher than that in the control group[(15.54±3.01)%],PLR in the observation group(162.40±78.85)was higher than that of control group(114.74±12.34),and the differences were statistically significance(P<0.05).There was no significant difference in gender,age,body mass index,smoking history,diabetes,hypertension,and hyperlipidemia between the poor prognosis group and the good prognosis group(P>0.05).There were significant differences in Killip classification,PLT,PDW,and PLR levels between the poor prognosis group and the good prognosis group(P<0.05).Multivariate Logistic regression analysis showed that elevated PLT,PDW and PLR levels were independent risk factors for poor prognosis in patients with AMI(P<0.05).Spearman correlation analysis showed that Killip grade was positively correlated with PLT,PDW and PLR levels(r=0.702,0.664,0.302,P<0.05).Pearson correlation analysis showed that PLT level was positively correlated with PDW and PLR levels(r=0.361,0.507,P<0.05),PDW level was positively correlated with PLR level(r=0.596,P<0.05).Conclusion The levels of PLT,PDW and PLR in patients with AMI are increased,and they are positively correlated with Killip classification in patients with AMI.PLT,PDW and PLR can be used as good indicators to predict the prognosis of patients with AMI,and have important clinical significance for the prevention and treatment of AMI.