首页|PLR、NLR以及血清IL-33、BNP水平预测急性心肌梗死院内转归不良的临床价值

PLR、NLR以及血清IL-33、BNP水平预测急性心肌梗死院内转归不良的临床价值

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目的 探讨血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)、中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)以及血清白细胞介素-33(interleukin-33,IL-33)、脑钠肽(brain natriuretic peptide,BNP)水平预测急性心肌梗死(acute myocardial infarction,AMI)院内转归不良的临床价值.方法 回顾性分析2021 年1 月~2023 年1 月本院收治的92 例行经皮冠状动脉介入(percutaneous coronary intervention,PCI)术的AMI患者的临床资料,术后统计其住院期间主要不良心血管事件(major adverse cardiovascular events,MACE)发生情况,为MACE组(n=20)与无MACE组(n=72).比较两组基线资料[性别、年龄、身体质量指数(body mass index,BIM)、手术时间、心梗史、合并疾病、饮酒史、吸烟史、梗死部位]以及PLR、NLR、血清IL-33、BNP水平的差异,通过受试者工作特征(receiver operating char-acteristic,ROC)曲线分析PLR、NLR、血清IL-33、BNP水平预测AMI患者PCI术后发生MACE的价值,最后采用多因素Logistic回归分析明确AMI患者PCI术后发生MACE的危险因素.结果 92 例患者中MACE发生率21.74%(20/92),无MACE组发生率78.26%(72/92).两组性别、年龄、BMI、手术时间、心梗史、合并疾病、饮酒史、吸烟史、梗死部位占比比较差异无统计学意义(P>0.05);MACE组PLR、NLR、血清IL-33、BNP水平显著高于无 MACE组,差异有统计学意义(P<0.05).经 ROC分析显示,PLR、NLR、血清 IL-33、BNP 水平均可用于预测 AMI 患者 PCI 术后 MACE 发生,曲线下面积分别为0.600、0.783、0.885、0.639,P均<0.05.经多因素Logistic回归分析显示,PLR≥137.245、NLR≥4.525、IL-33≥400.83 μg/L、BNP≥273.375 pg/mL是AMI患者PCI术后发生MACE的危险因素,P均<0.05.结论 AMI患者PCI术后发生 MACE受诸多因素影响,其中当 PLR≥137.245、NLR≥4.525、IL-33≥400.83 μg/L、BNP≥273.375 pg/mL时可预测MACE发生,临床医师治疗期间应密切关注.
The clinical value of PLR,NLR,and serum IL-33,BNP levels in predicting adverse outcomes in acute myocardial infarction in the hospital
Objective To explore the clinical value of platelet to lymphocyte ratio(PLR),neutrophil to lymphocyte ratio(NLR),and serum levels of interleukin-33(IL-33)and brain natriuretic peptide(BNP)in predicting adverse outcomes in acute myocardial infarction(AMI)patients.Methods A retrospective analysis was conducted on the clinical data of 92 AMI pa-tients who underwent percutaneous coronary intervention(PCI)in our hospital from January 2021 to January 2023.The incidence of major adverse cardiovascular events(MACE)during hospitalization was analyzed postoperatively,and they were divided into the MACE group(n=20)and the non MACE group(n=72).The baseline data[gender,age,body mass index(BIM),operation time,myocardial infarction history,comorbidity,drinking history,smoking history,infarction site]and the difference of PLR,NLR,serum IL-33,BNP levels between the two groups were compared,and the value of PLR,NLR,serum IL-33,BNP levels to pre-dict MACE in AMI patients after PCI was analyzed through receiver operating characteristic(ROC)curve.Finally,multivariate logistic regression analysis was used to identify the risk factors for MACE in AMI patients after PCI.Results Among the 92 patients,the incidence of MACE was 21.74%(20/92),while the incidence of MACE was 78.26%(72/92)in the non MACE group.There was no statistically significant difference between the two groups in terms of gender,age,BMI,surgical time,history of myocardial infarction,comorbidities,history of alcohol consumption,smoking history,and proportion of infarct site(P>0.05);The levels of PLR,NLR,serum IL-33,and BNP in the MACE group were significantly higher than those in the non MACE group,with statistical significance(P<0.05).After ROC analysis,it was found that PLR,NLR,serum IL-33,and BNP levels could predict the occurrence of MACE in AMI patients after PCI.The areas under the curve were 0.600,0.783,0.885,and 0.639,respectively,with P all<0.05.Multiple logistic regression analysis showed that PLR≥137.245,NLR≥4.525,IL-33≥400.83 μg/L,and BNP≥273.375 pg/mL were risk factors for MACE in AMI patients after PCI,with all P<0.05.Conclusion The occurrence of MACE in AMI patients after PCI is influenced by many factors,among which PLR≥137.245,NLR≥4.525,IL-33≥400.83 μg/L,BNP≥273.375 pg/mL can predict the occurrence of MACE.Therefore,clinicians should pay close attention during treatment.

platelet to lymphocyte rationeutrophil to lymphocyte ratiointerleukin-33brain natriuretic peptideacute myocardial infarctionpoor outcome in the hospital

孙姣、吴婷、沈沁

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中国人民解放军联勤保障部队第904 医院 心血管内科,江苏 无锡 214000

血小板与淋巴细胞比值 中性粒细胞与淋巴细胞比值 白细胞介素-33 脑钠肽 急性心肌梗死 院内转归不良

江苏省自然科学基金

BK20201139

2024

哈尔滨医科大学学报
哈尔滨医科大学

哈尔滨医科大学学报

CSTPCD
影响因子:1.117
ISSN:1000-1905
年,卷(期):2024.58(2)
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