| 刘红军,杨杰.平均血小板体积联合Gensini评分预测ST段抬高型心肌梗死患者急诊经皮冠状动脉介入术近期预后[J].中国介入影像与治疗学,2019,16(3):139-143 |
| 平均血小板体积联合Gensini评分预测ST段抬高型心肌梗死患者急诊经皮冠状动脉介入术近期预后 |
| Mean platelet volume combined with Gensini score in prediction of short-term prognosis in patients with acute ST segment elevation myocardial infarction after emergency percutaneous coronary intervention |
| 投稿时间：2018-05-24 修订日期：2018-10-25 |
| DOI：10.13929/j.1672-8475.201805029 |
| 中文关键词: 心肌梗死 平均血小板体积 Gensini评分 经皮冠状动脉介入术 预后 |
| 英文关键词:myocardial infarction mean platelet volume Gensini score percutaneous coronary intervention prognosis |
| 基金项目:河南省科技发展计划（142102310084）。 |
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| 中文摘要: |
| 目的 探讨平均血小板体积（MPV）联合Gensini评分预测急性ST段抬高型心肌梗死（STEMI）患者急诊经皮冠状动脉介入术（PCI）近期预后的价值。方法 对186例接受急诊PCI治疗的STEMI患者，术前完善相关实验室检查、检测MPV，并根据冠状动脉造影检查结果进行Gensini评分；术后随访记录主要不良心血管事件（MACE）发生情况，并进行统计学分析。结果 186例中，PCI术后36例发生MACE（MACE组），150例未发生MACE（非MACE组）。2组间总胆固醇（TC）、血小板计数（Plt）、D-二聚体、N末端脑钠肽前体（NT-proBNP）、MPV、Gensini评分及病变累及冠状动脉3支血管的比例差异均有统计学意义（P均<0.05）。MPV、Gensini评分、Plt、NT-proBNP及病变累及冠状动脉3支血管是STEMI患者PCI术后发生MACE的独立危险因素（P均<0.05）。以MPV（阈值0.86 fl）联合Gensini评分（阈值82.17分）预测STEMI患者急诊PCI术后发生MACE的ROC曲线AUC为0.92[95% CI（0.87，0.98）]，敏感度为92.70%，特异度为83.33%。结论 STEMI患者急诊PCI术后近期MACE的发生与术前MPV及Gensini评分有关；MPV联合Gensini评分可用于筛查PCI术后高危患者。 |
| 英文摘要: |
| Objective To investigate the value of mean platelet volume (MPV) combined with Gensini score in predicting short-term prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI) after emergency percutaneous coronary intervention (PCI). Methods A total of 186 patients with STEMI who underwent emergency PCI were enrolled. The relevant laboratory tests were completed before PCI, and MPV was detected. Gensini score was obtained according to the results of coronary angiography. The occurrence of major adverse cardiovascular events (MACE) after PCI was recorded. Then statistical analysis was performed. Results There were 36 patients with MACE after PCI (MACE group) and 150 patients without MACE (non-MACE group). The total cholesterol (TC), platelet count (Plt), D-dimer, N-terminal pro-brain natriuretic peptide (NT-proBNP), MPV, Gensini score and the proportion of lesions involving three vessels of coronary arteries were statistically different between the two groups (all P<0.05). MPV, Gensini score, Plt, NT-proBNP and lesions involving three vessels of coronary arteries were independent risk factors for MACE after PCI in patients with STEMI (all P<0.05). ROC analysis showed that the AUC for MPV (threshold as 0.86 fl) combined with Gensini score (threshold as 82.17) in predicting MACE in patients with STEMI after PCI was 0.92(95% CI[0.87, 0.98]), the sensitivity and specificity was 92.70% and 83.33%, respectively. Conclusion The occurrence of MACE in patients with STEMI after emergency PCI is related to MPV and Gensini score before intervention. MPV combined with Gensini score can be used to screen out high-risk patients. |
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