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中性粒细胞与淋巴细胞比值及血小板相关参数联合预测 ST 段抬高型心肌梗死患者直接经皮冠状动脉介入治疗后无复流现象。

The combination of neutrophil-to-lymphocyte ratio and platelet correlation parameters in predicting the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction.

机构信息

Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.

Department of Cardiac Function, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.

出版信息

Scand Cardiovasc J. 2020 Dec;54(6):352-357. doi: 10.1080/14017431.2020.1783457. Epub 2020 Jun 29.

Abstract

To evaluate the predictive value of the neutrophil-to-lymphocyte ratio (NLR), mean platelet volume (MPV), and platelet distribution width (PDW) for the no-reflow phenomenon in patients with ST-segment elevation myocardial infarction. : Patients who underwent primary percutaneous coronary intervention from January 2017 to April 2019 were consecutively enrolled in this study and were split into the control and no-reflow groups. Logistic regression analysis was used to determine the independent predictors. Receiver operating characteristic curves were carried out to evaluate the predictive value. : A total of 455 patients were included and the incidence of the no-reflow was 19.6%. After the adjustment of confounding factors, logistic regression analyses showed that the NLR (odds ratio [OR] per unit increase: 1.107, 95% confidence interval [CI]: 1.044-1.172,  = .001), MPV (OR: 1.398, 95% CI: 1.010-1.937,  = .044), and PDW (OR: 1.392, 95% CI: 1.012-1.914,  = .042) were all independent predictors. In the prediction of the no-reflow, the NLR had the largest area under the curve of 0.650 (95% CI: 0.593-0.708) with 90% sensitivity and 36% specificity. The area under the curve of the combination of NLR + MPV was 0.676 and that of NLR + PDW was 0.654. : The NLR, MPV and PDW are all associated with the no-reflow. However, there is no significant difference in the predictive value of these indicators. The combinations of NLR and platelet-associated parameters also do not show a better predictive value than NLR alone.

摘要

评价中性粒细胞与淋巴细胞比值(NLR)、血小板平均体积(MPV)和血小板分布宽度(PDW)对 ST 段抬高型心肌梗死患者无复流现象的预测价值。

方法

本研究连续纳入 2017 年 1 月至 2019 年 4 月行直接经皮冠状动脉介入治疗的患者,并将其分为对照组和无复流组。采用 Logistic 回归分析确定独立预测因素。绘制受试者工作特征曲线评估预测价值。

结果

共纳入 455 例患者,无复流发生率为 19.6%。调整混杂因素后,Logistic 回归分析显示 NLR(每单位增加的优势比[OR]:1.107,95%置信区间[CI]:1.044-1.172, = .001)、MPV(OR:1.398,95% CI:1.010-1.937, = .044)和 PDW(OR:1.392,95% CI:1.012-1.914, = .042)均为独立预测因素。在无复流的预测中,NLR 的曲线下面积最大,为 0.650(95% CI:0.593-0.708),敏感性为 90%,特异性为 36%。NLR+MPV 的曲线下面积为 0.676,NLR+PDW 的曲线下面积为 0.654。

结论

NLR、MPV 和 PDW 均与无复流相关,但这些指标的预测价值无显著差异。NLR 与血小板相关参数的组合也没有比 NLR 单独使用表现出更好的预测价值。

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