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基线血小板-白细胞聚集体水平对非ST段抬高型急性冠状动脉综合征患者近期预后的预测价值

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2014年第6期
页码:
680-683
栏目:
临床研究
出版日期:
2014-06-25

文章信息/Info

Title:
Predictive value of admission platelet-leukocyte-aggregate to short-term major adverse cardiac events in patients with non-ST-segment elevation acute coronary syndrome
作者:
湛 疆; 张 淳
(鄂州市中心医院心血管内科，湖北 鄂州 436000)
Author(s):
ZHAN Jiang;  ZHANG Chun
(Department of Cardiology, Ezhou Central Hospital, Ezhou 436000, Hubei, China)
关键词:
冠状动脉疾病; 血小板-白细胞聚集体; 血小板活化; 预后
Keywords:
coronary disease;  platelet-leukocyte-aggregate;  platelet activation;  prognosis
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的:探讨基线血小板-白细胞聚集体（PLA）水平对非ST段抬高型急性冠状动脉综合征（NSTE-ACS）患者近期主要不良心脏事件（MACE）的预测价值。方法： 共纳入114例患者，其中NSTE-ACS组72例，对照组42例，比较两组患者相关临床资料；采用全球急性冠状动脉事件注册（GRACE）评分将NSTE-ACS患者分为低危组和高危组，比较两组PLA、血小板-单核细胞聚集体（PMA）、血小板-中性粒细胞聚集体（PNA）及血小板-淋巴细胞聚集体（PlyA）水平，并对PLA、PMA、PNA 及PlyA水平与GRACE评分分数进行Spearman相关性检验； 对NSTE-ACS组患者近期（出院后8个月内）MACE进行随访，使用受试者工作特征（ROC）曲线评价基线PLA水平对NST-ACS患者近期MACE的预测价值。结果： 与对照组相比，NSTE-ACS组PLA、PMA、PNA及PLyA显著升高（P<0.01）；高危组NSTE-ACS患者PLA、PMA、PNA及PLyA较低危组升高（P<0.01）；NSTE-ACS患者GRACE评分分数与基线PLA、PMA、PNA及PlyA水平均成正相关（分别为r=0.597、r=0.634、r=0.487和r=0.435，均P<0.05）；经随访，共有14%的NSTE-ACS患者发生了近期MACE；入院时PLA水平预测NSTE-ACS组出院后8个月内MACE的ROC曲线下面积为0.753（95%CI：0.737-0.779，P<0.05）。结论： 基线PLA水平升高可能预示NSTE-ACS患者的不稳定状态；基线PLA水平不仅可用于NSTE-ACS患者的早期快速危险分层，还可对NSTE-ACS患者近期MACE进行预测。
Abstract:
AIM:To explore the predictive value of admission platelet-leukocyte-aggregate (PLA) to major adverse cardiac events (MACE) in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). METHODS: According to clinical diagnosis, 114 hospitalized patients were divided into two groups: NSTE-ACS group (n=72) and control (CTL) group (n=42), and clinical data of the two groups were collected and analyzed. NST-ACS group was further divided into low-risk (LR) group and high-risk (HR) group according to the global registry of acute coronary events (GRACE) scores. The platelet-monocyte-aggregate (PMA), the platelet-neutrophile-aggregate (PNA) and the platelet- lymphocyte-aggregate (PlyA) were compared between LR group and HR group. Moreover, the correlations of PLA, PMA, PNA and PlyA to the GRACE scores were also evaluated and the receiver operating characteristic (ROC) curve was used to assess the value of PLA in predicting short-term MACE in patients with the NSTE-ACS. RESULTS: Compared with those in CTL group, PLA, PMA, PNA and PlyA in the NSTE-ACS group were significantly higher (P<0.01), and PLA, PMA, PNA and PlyA in high-risk group were also markedly higher than those in low-risk group (P<0.01). Spearman correlation analysis showed that the GRACE scores was positively correlated with PLA, PMA, PNA and PlyA (r= 0.617, 0.634, 0.527 and 0.492, P<0.05). During the follow up, MACE occurred in 13.89% (10/72) of the NST-ACS patients. The ROC curve showed the area under curve (AUC) of admission PLA was 0.753 (P<0.05, 95%CI: 0.737-0.779) in predicting the short-term risk of MACE. CONCLUSION: Admission PLA is a good predictor for short-term MACE in patients with NSTE-ACS.

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备注/Memo

备注/Memo:
收稿日期：2014-04-01.
作者简介：湛疆，主治医师Email:zj_0127@sina.com
更新日期/Last Update: 2014-07-10