急性ST段抬高型心肌梗死患者淋巴细胞/单核细胞比值与无复流及短期预后的相关性

目的 本研究旨在评估ST段抬高型心肌梗死(STEMI)患者淋巴细胞/单核细胞比值(LMR)与行直接经皮冠状动脉介入术(PPCI)后无复流(NRP)及院内主要不良心血管事件(MACE)的关系。方法 研究共纳入确诊急性ST段抬高型心肌梗死患者139例,根据心肌梗死溶栓治疗(TIMI)血流分级,将患者分为无复流组(n=25)和对照组(n=114)。无复流定义为TIMI ≤2级,对照组定义为TIMI 3级。分析无复流的危险因素,评估LMR在无复流患者及院内主要MACE预测中的应用价值。结果 无复流组与对照组相比,淋巴细胞计数、LMR值较低,球囊扩张后冠脉残余血栓征象发生率、替罗非班使用率、院内MACE较高,差异具有统计学意义(P<0.05);多因素logistic回归分析结果显示,淋巴细胞计数升高会增加STEMI患者PPCI术后NRP的风险,LMR值升高会降低NRP发生的风险。根据LMR值2.815将患者分为两组,LMR低分组MACE发生率较高。结论 淋巴细胞计数升高是预测无复流的独立危险因素,LMR值升高是无复流的保护因素,同时LMR对住院期间MACE也有一定的预测价值。

Correlation between lymphocyte/monocyte ratio and no-reflow and short-term prognosis in patients with acute ST-segment elevation myocardial infarction

Objective To assess the correlation between lymphocyte/monocyte ratio (LMR) and no-reflow (NRP) and in-hospital major adverse cardiovascular events after primary coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction.Methods One hundred and thirty-nine patients with acute ST-segment elevation myocardial infarction were included in this study. The patients were divided into the NRP group (n=25) and the control group (n=114) according to thrombolytic therapy for myocardial infarction (TIMI) blood flow grade. No reflow was defined as TIMI ≤ 2 and the control group as TIMI 3. The risk factors of NRP were analyzed and the application value of LMR was evaluated in the prediction of NRP patients and in-hospital major adverse cardiovascular events (MACE).Results Compared with those in the control group, the lymphocyte count and LMR value in the NRP group were lower; the incidence of coronary residual thrombosis signs, the use rate of teicoplanin, and in-hospital MACE after balloon dilatation were higher in the NRP group, and the differences were statistically significant (P<0.05); the results of multivariate logistic regression analysis showed that the lymphocyte count rise could increase the risk of NRP after PPCI in STEMI patients, and the LMR rise could reduce the risk of NRP. The patients were divided into two groups according to the LMR value of 2.815, and the incidence of MACE was higher in the low LMR group.Conclusion The lymphocyte count rise was independent risk factors for NRP, and the LMR rise was the protective factor for NRP. LMR also has some predictive value for MACE during hospitalization.