经冠状动脉介入术后患者中性粒细胞变化与预后的相关性探讨

目的评价行经冠状动脉介入术（PCI）前后患者中性粒细胞水平的变化与术后预后的相关性。方法选取成功施行PCI术的患者202例,术前4h内和术后12h内检测患者中性粒细胞水平。根据术后中性粒细胞水平将患者分为3组：A组61例（中性粒细胞〈4.71×109/L﹚,B组99例[中性粒细胞：（4.71～7.70）×109/L],C组42例（中性粒细胞〉7.70×109/L﹚。所有患者随访24个月,记录在随访期间近期（30d）和远期（24个月）发生的不良心血管事件（CV）。采用logistic回归分析PCI术后中性粒细胞水平与患者在近期及远期CV发生的关系,同时采用Kap-lan-Meier生存曲线评价PCI术后不同的中性粒细胞水平的患者在近期和远期生存率的差异。结果 （1）C组术前后中性粒细胞多于A组,中性粒细胞变化率、30d及24个月CV事件发生率高于A组,差异均有统计学意义（P〈0.05或P〈0.01）;B组术后中性粒细胞多于A组,中性粒细胞变化率及24个月CV事件发生率高于A组,差异均有统计学意义（P〈0.05）;且除术前中性粒细胞计数外,C组其余指标与B组比较,差异均有统计学意义（P〈0.05）。（2）logistic回归分析结果显示,随着术后中性粒细胞水平的升高,患者CV事件的发生率也随之升高,A组与B组回归分析OR值（远期心血管发生情况）为1.9125,而A组与C组回归分析OR值为3.4680,提示风险上升。（3）A组远期生存率高于B、C组（P〈0.05或P〈0.01）,且B组远期生存率亦高于C组（P〈0.05）。提示：随着术后中性粒细胞水平的上升,患者的远期生存率呈现出下降趋势。结论中性粒细胞水平与患者PCI术后预后有密切的相关性。

Correlation discuss of the change of neutrophile granulocyte and prognosis in patient after percutaneous coronary intervention

Objective To explore the correlation of the change of neutrophile granulocyte and prognosis in patient after percutaneous coronary intervention（PCI）.Methods Enrolled 202 cases patients who had undergone PCI successfully,and examined the level of the neutrophile granulocyte in 4h before PCI and in 12h after PCI.According to the level of the neutrophile granulocyte ater PCI,the patients were divided into 3 groups：A group（neutrophile granulocyte4.71×109/L,n=61）;B group[neutrophile granulocyte：（4.71~8.71）×109/L,n=99];C group（neutrophile granulocyte8.71×109/L,n=62）.All the patients were follow-up 24 months,and the cardiac events（CV） were recorded during the short-term（30d） and the long-term（24 months）.And explored the difference in the survival rate of the short-term and long-term between the dissimilar level of neutrophil count after PCI with Kaplan-Meier survival analysis.Results（1）Before and after surgery,the neutrophile granulocyte of C group was more than that of A group,the rate of change of neutrophils,30d and 24-month incidence of CV event were higher than those of A group（P〈0.05 or P〈0.01）;Neutrophile granulocyte of B group were more than that of A group,the rate of change of neutrophils and 24-month incidence of CV event were higher than those of A group（P〈0.05）;And the addition of preoperative external neutrophile granulocyte,the other indexes of C group compared with B group（P〈0.05）.（2）Logistic regression analysis showed that patients with elevated levels of neutrophils,CV event in patients with an increasing rate,A group and B group regression analysis OR value（long-term incidence of cardiovascular） was 1.9125,while the A group and C group regression analysis,OR=3.4680,suggested increased risk.（3）Long-term survival rate of A group was higher than that of B,C group（P〈0.05 or P〈0.01）,and long-term survival rate of B group was higher than that of C group（P〈0.05）.Tip：With the level of neutrophils after the rise in long-term survival of patients showing a downward trend.Conclusion Neutrophil granulocyte level and prognosis in patients after PCI has closely relation.