中性粒细胞淋巴细胞比值与急性ST段抬高型心肌梗死患者PCI术后无复流相关性研究

目的探讨中性粒细胞淋巴细胞比值(NLR)与急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉(冠脉)介入治疗(PCI)后无复流的相关性,为STEMI患者的早期危险分层提供参考。方法选取2015年1月至2017年1月于北京大学民航总医院心内科收治的198例接受PCI的STEMI患者纳入研究,根据心肌梗死溶栓治疗(TIMI)分级标准确定患者是否发生冠脉无复流,分为无复流组和正常血流组。比较两组患者基线资料,ROC工作曲线评价NLR对无复流的预测价值,多元Logistic回归分析无复流的危险因素。结果198例患者中,出现无复流39例(19.7%)。NLR预测无复流的ROC曲线下面积0.764,最佳临界值3.25,此时敏感度为78.8%,特异度为70.5%。多元Logistic回归分析显示,既往冠状动脉疾病史,PCI前TIMI血流0级,NLR≥3.25,多支血管病变为冠脉无复流的独立危险因素。结论NLR有助于预测STEMI患者PCI术后无复流的发生,以便针对高风险患者提前采取积极干预措施,改善预后。

Correlation between neutrophil-lymphocyte ratio and no-reflow after PCI in patients with acute ST-segment elevation myocardial infarction

Objective To investigate the correlation between neutrophil-lymphocyte ratio(NLR)and noreflow after PCI in patients with acute ST-segment elevation myocardial infarction(STEMI),and to provide reference for early risk stratification of STEMI patients.Methods STEMI patients undergone PCI(n=198)were chosen from Department of Cardiology of Beijing Civil Aviation General Hospital from Jan.2015 to Jan.2017.All patients were divided,according to TIMI classification criteria,into no-reflow group and normal flow group.The baseline data was compared between 2 groups.The predictive value of NLR to no-reflow was reviewed by using ROC curve.The risk factors of no-reflow were analyzed by using multiple Logistic regression analysis.Results Among 198 patients,there were 39 had no-reflow(19.7%).ROC curve showed that AUC of NLR was 0.764 in predicting no-reflow,and the optimum critical value was 3.25,sensitivity was 78.8% and specificity was 70.5%.The results of multiple Logistic regression analysis showed that previous history of coronary artery diseases,grade 0 of TIMI classification flow before PCI,NLR≥3.25 and multi-vessel lesions were independent risk factors of noreflow.Conclusion NLR is helpful in predicting no-reflow after PCI in STEMI patients,so that active intervention measures can be taken in advance for patients with high risks and prognosis will be improved.