红细胞分布宽度和血小板分布宽度对急性心肌梗死患者经皮冠状动脉介入术治疗中无复流的预测价值

Predictive value of erythrocyte distribution width and platelet distribution width for no-reflow during coronary intervention for acute heart infarction

目的分析红细胞分布宽度(RDW)和血小板分布宽度(PDW)对急性心肌梗死经皮冠状动脉介入术治疗中无复流的预测价值。方法选取2020年1月至2023年6月泉州医学高等专科学校附属人民医院收治的297例经皮冠状动脉介入术治疗的急性心肌梗死患者为研究对象。根据经皮冠状动脉介入术治疗中有无发生复流情况分为无复流组(n=35)与复流组(n=262)。比较两组临床资料、实验室结果(红细胞压积、血小板压积、淋巴细胞计数、淋巴细胞比率、单核细胞计数、血糖、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇)、RDW、PDW。采用受试者特征曲线(ROC)分析RDW和PDW对急性心肌梗死经皮冠状动脉介入术治疗中无复流的预测意义。结果复流组淋巴细胞计数、淋巴细胞比率低于无复流组,血糖高于无复流组,差异有统计学意义(P<0.05)。两组红细胞压积、血小板压积、单核细胞计数、三酰甘油、总胆固醇以及高密度脂蛋白胆固醇、低密度脂蛋白胆固醇比较,差异未见统计学意义(P>0.05)。复流组RDW、PDW低于无复流组,差异有统计学意义(P<0.05)。RDW、PDW指标检测灵敏度分别为71.43%、65.71%,显著低于两者联合检测(80.00%);RDW、PDW指标检测特异度分别为83.59%、84.73%,显著低于两者联合检测(88.16%);RDW、PDW指标检测准确度分别为81.82%、82.49%,显著低于两者联合检测(87.20%,P<0.05)。结论RDW、PDW对急性心肌梗死经皮冠状动脉介入术治疗中无复流现象检测效果较好。

Objective To analyze the predictive value of red blood cell distribution width(RDW)and platelet distribution width(PDW)for no reflow during coronary intervention(PCI)for acute myocardial infarction.Methods A total of 297 patients with acute myocardial infarction treated with coronary intervention at Quanzhou Medical College Affiliated People's Hospital from January 2020 to June 2023 were selected as the study subjects.According to the occurrence of reflow during percutaneous coronary intervention,the patients were divided into two groups:non reflow group(n=35)and reflow group(n=262).The clinical data,laboratory results(hematocrit,plateletcrit,lymphocyte count,lymphocyte ratio monocyte count,blood glucose,triglycerides,total cholesterol,high-density lipoprotein,low-density lipprotein),red blood cell distribution width(RDW),and platelet distribution width(PDW)values between two groups were compared.The predictive significance of receiver operating characteristic(ROC)curve analysis for no reflow during coronary intervention treatment in acute myocardial infarction with RDW and PDW was analyzed.Results The lymphocyte count and lymphocyte ratio of the reflow group were lower than those in the non reflow group,and blood glucose was higher than those in the non reflow group,with significant differences(P<0.05).There was no significant difference between the two groups in hematocrit,plateletorit,monocyte count,triglycerides,total cholesterol,high-density lipoprotein,and low-density lipoprotein(P>0.05).The values of RDW and PDW in the reflow group were lower than those in the non reflow group,and the differences were significant(P<0.05).The sensitivity of RDW and PDW indicators detection was 71.43%and 65.71%,respectively,which were significantly lower than that(80.00%)of the combined detection of the two;the specificity of RDW and PDW index detection was 83.59%and 84.73%,respectively,which were significantly lower than that(88.16%)of the combined detection of the two;the accuracy of RDW and PDW index detection was 81.82%and 82.49%,respectively,which were significantly lower than that(87.20%)of the combined detection of the two(P<0.05).Conclusions RDW and PDW have a good effect on the detection of no reflow in coronary interventional therapy of acute myocardial infarction.