血小板参数对急性心肌梗死患者急诊介入治疗后主要不良心脏事件的影响

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摘要目的探讨急性ST段抬高性心肌梗死（STEMI）患者血小板参数与急诊经皮冠状动脉介入（PCI）术后主要不良心脏事件（MACE）发生的关系，及评估各血小板参数对MACE的预测效能。方法回顾性分析2013年7月~2017年7月北京市大兴区人民医院行急诊PCI的急性STEMI患者365例的临床资料，对患者进行随访，记录患者随访期间MACE发生情况。根据有无MACE发生分为MACE组（144例）和无MACE组（221例），比较两组患者临床指标及各血小板参数方面的差异。结果两组患者在年龄、高血压病史、血小板计数、平均血小板体积、血小板分布宽度方面差异有统计学意义（P < 0.05）。Logistic回归分析发现，平均血小板体积（MPV）是STEMI患者接受急诊PCI术后近期MACE发生的独立预测因子（OR = 4.54，95％CI：1.11～18.47，P = 0.035）。MPV预测MACE的灵敏度和特异度分别为72.9%和72.7%。结论 MPV增大与STEMI患者急诊PCI术后近期MACE发生有关，可能是此类患者近期预后的独立预测因子。

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	王文斌菅宏伟程国杰唐学弘李馨

关键词 ：急性ST段抬高性心肌梗死, 经皮冠状动脉介入术, 血小板参数, 主要不良心脏事件

Abstract：Objective To explore the relationship between platelet parameters and the incidence of major adverse cardiac events (MACE) in STEMI patients treated with percutaneous coronary intervention (PCI), and evaluate the predictive efficacy of each platelet parameter on MACE events. Methods From July 2013 to July 2017, the clinical data of 365 STEMI patients treated with primary PCI in the Daxing District People's Hospital were retrospectively analyzed. The date of MACE patient during the follow-up were recorded. According to the follow-up results, they were divided into two groups: MACE group (144 cases) and no MACE group (211 cases). The differences in baseline data and platelet parameters between the two groups were compared. Results There were significant differences between the two groups in age, hypertension history, platelet count, mean platelet volume and platelet distribution width (P < 0.05). Logistic regression analysis showed that MPV was independently associated with short-term MACE in acute STEMI after primary PCI (OR = 4.54, 95%CI: 1.11-18.47, P = 0.035). The sensitivity and specificity of MPV in predicting MACE were 72.9 % and 72.7%, respectively. Conclusion The increase in MPV is associated with recent MACE in STEMI patients after primary PCI and may be an independent predictor of the short-term prognosis of such patients.

Key words： ST segment elevation myocardial infarction Percutaneous coronary intervention Platelet parameters Major adverse cardiac events

作者简介: 王文斌（1977.1-），男，副主任医师；研究方向：冠脉介入治疗。

引用本文:

王文斌菅宏伟程国杰唐学弘李馨. 血小板参数对急性心肌梗死患者急诊介入治疗后主要不良心脏事件的影响[J]. 中国医药导报, 2018, 15(17): 48-51.
WANG Wenbin JIAN Hongwei CHENG Guojie TANG Xuehong LI Xin. Effects of platelet parameters on incidence of major adverse cardiac events in patients with acute myocardial infarction after primary percutaneous interventional therapy. 中国医药导报, 2018, 15(17): 48-51.

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