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炎症和血液学指标作为冠状动脉介入治疗后微功能障碍的简单实用严重程度预测指标:系统评价和荟萃分析。

Inflammatory and Hematological Indices as Simple, Practical Severity Predictors of Microdysfunction Following Coronary Intervention: A Systematic Review and Meta-Analysis.

机构信息

Department of Coronary Care Unit, Tianjin Chest Hospital, Tianjin, China.

Institute of Cardiovascular Diseases, Tianjin Chest Hospital, Tianjin, China.

出版信息

Angiology. 2020 Apr;71(4):349-359. doi: 10.1177/0003319719896472. Epub 2020 Feb 4.

Abstract

C-reactive protein (CRP) and high-sensitivity CRP (hsCRP), along with a series of hematological indices, platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), mean platelet volume (MPV), platelet distribution width (PDW), and red blood cell distribution width (RDW), are regarded to be related to the incidence of no-reflow or slow flow. Clinical studies were retrieved from the electronic databases of PubMed, EMBASE, Google Scholar, Clinical Trials, and science direct from their inception to August 24, 2019. A total of 21 studies involving 7403 patients were included in the meta-analysis. Pooled analysis results revealed patients with higher hsCRP (odds ratio [OR] = 1.03, 95% confidence interval [CI], 1.01-1.05, = .006), hsCRP (OR = 1.04, 95% CI: 1.0-1.08, = .012), NLR (OR = 1.23, 95% CI: 1.11-1.37, < .0001), PLR (OR = 1.13, 95% CI: 1.07-1.20, < .0001), and MPV (OR = 2.13, 95% CI: 1.57-2.90, < .0001) all exhibited significantly higher no-reflow incidence, but there was no significant association between no-reflow risk and RDW or PDW. Patients with higher CRP/hsCRP also performed higher rate of slow flow (OR = 1.06, 95% CI: 1.01-1.11, = .018). Preangiographic CRP/hsCRP could independently predict no-reflow and slow flow. Moreover, some hematological indices are associated with no-flow.

摘要

C-反应蛋白(CRP)和高敏 C-反应蛋白(hsCRP)以及一系列血液学指标,血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)、平均血小板体积(MPV)、血小板分布宽度(PDW)和红细胞分布宽度(RDW),被认为与无复流或慢血流的发生有关。从电子数据库 PubMed、EMBASE、Google Scholar、ClinicalTrials 和 ScienceDirect 中检索到临床研究,从其成立到 2019 年 8 月 24 日。共有 21 项涉及 7403 名患者的研究纳入荟萃分析。汇总分析结果显示,hsCRP 较高的患者(优势比[OR] = 1.03,95%置信区间[CI],1.01-1.05, =.006)、hsCRP(OR = 1.04,95%CI:1.0-1.08, =.012)、NLR(OR = 1.23,95%CI:1.11-1.37, <.0001)、PLR(OR = 1.13,95%CI:1.07-1.20, <.0001)和 MPV(OR = 2.13,95%CI:1.57-2.90, <.0001)的无复流发生率均显著升高,但无复流风险与 RDW 或 PDW 之间无显著相关性。CRP/hsCRP 较高的患者也表现出更高的慢血流率(OR = 1.06,95%CI:1.01-1.11, =.018)。术前 CRP/hsCRP 可独立预测无复流和慢血流。此外,一些血液学指标与无血流相关。

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