摘要
目的探讨血小板平均体积(MPV)/血小板计数(PC)比值与接受经皮冠状动脉介入治疗(PCI)的冠心病患者长期预后的关系。方法采用回顾性队列研究,选取2008年1月—2016年12月在新疆医科大学第一附属医院诊治的冠心病PCI术后患者的一般资料,包括入院血小板参数、生化数据、心血管疾病相关危险因素等资料。设定随访终点:全因死亡(ACM)、心血管死亡(CM)、出血事件、主要不良心血管事件(MACE),并进行电话随访。最终纳入6046例患者,选取患者入院MPV/PC比值,利用ROC曲线评估患者MPV/PC值的最佳临床截点后进行分组,应用多因素Cox回归分析比较不同组别与远期预后的相关性。结果基线资料分析表明,与MPV/PC低值组相比,MPV/PC高值组全因死亡率(6.4%比4.5%,P=0.001)、心源性死亡率(5.6%比3.4%,P<0.001)、MACE事件发生率(15.8%比11.5%,P<0.001)显著升高。多因素Cox回归分析显示,与MPV/PC低值组相比,MPV/PC高值组全因死亡风险增加46.6%(HR=1.466,95%CI:1.159~1.852,P=0.001),心源性死亡增加64.7%(HR=1.647,95%CI:1.271~2.137,P<0.001),MACE发生率增加31.8%(HR=1.318,95%CI:1.138~1.527,P<0.001)。结论MPV/PC比值升高显著增加PCI术后不良事件的发生率,其水平的升高是全因死亡及心源性死亡的独立危险因素。
Aim To determine whether the mean platelet volume/platelet count(MPV/PC)ratio on admission has any predictive value for long-term prognosis in patients with coronary heart disease who underwent percutaneous coronary intervention(PCI).Methods A retrospective cohort study was conducted.The clinical data of 6046 patients after PCI who admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2008 to December 2016 were collected.Follow-up endpoints were:all cause mortality(ACM),cardiac mortality(CM),bleeding events and major adverse cardiovascular events(MACE).Receiver operating characteristic(ROC)curve analysis were used to determine the optimal MPV/PC ratio for grouping.Multi-factor Cox regression analysis was used to compare the correlation between different groups and long-term prognosis.Results The high MPV/PC group had higher ACM(6.4%vs 4.5%),CM(5.6%vs 3.4%),and MACE(15.8%vs 11.5%).Multivariate Cox regression analysis showed that compared with the low MPV/PC ratio group,the risk of all-cause death in the high-value group was increased by 46.6%(HR=1.466,95%CI:1.159~1.852,P=0.001),cardiac death increased by 64.7%(HR=1.647,95%CI:1.271~2.137,P<0.001);the incidence of MACE increased by 31.8%(HR=1.318,95%CI:1.138~1.527,P<0.001).Conclusion Higher MPV/PC ratio is associated with poor prognosis after PCI.It can be an independent risk factor for poor prognosis.
作者
荀一骊
吴婷婷
郑颖颖
马艳艳
王万荣
潘颖
马依彤
谢翔
XUN Yili;WU Tingting;ZHENG Yingying;MA Yanyan;WANG Wanrong;PAN Ying;MA Yitong;XIE Xiang(Department of Heart Center,the First Affiliated Hospital,Xinjiang Medical University,Urumqi,Xinjiang 830054,China)
出处
《中国动脉硬化杂志》
CAS
2021年第6期483-488,共6页
Chinese Journal of Arteriosclerosis
基金
新疆维吾尔自治区科技支疆项目(2019E0278)。
关键词
平均血小板体积
血小板计数
冠心病
长期预后
mean platelet volume
platelet count
coronary heart disease
long-term prognosis
