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