血小板平均容积对急性非ST 段抬高型心肌梗死 介入治疗患者长期预后的影响

Influence of mean platelet volume on long-term outcomes among patients with acute non-ST-segment elevation myocardial infarction treated with percutaneous coronary intervention

摘要:

目的 探讨血小板平均容积对急性非ST 段抬高型心肌梗死（NSTEMI）介入治疗患者长期预后的 影响。方法 选取2010 年1 月—2014 年10 月在中国医科大学附属盛京医院确诊为NSTEMI 且行经皮冠状动 脉介入（PCI）治疗的885 例患者。基于血小板平均容积（MPV）水平，将患者分为低MPV 组756 例（MPV<10.94 fl） 和高MPV 组129 例（MPV ≥ 10.94 fl）。通过单因素及多因素Cox 回归分析，研究MPV 对NSTEMI 行PCI 治疗患者预后的影响。结果 平均随访30.9 个月，与低MPV 组比较，高MPV 组全因死亡及心源性死亡率更 高（P <0.05）；多因素校正后Cox 分析显示，高MPV 是行PCI 的NSTEMI 患者全因死亡[H^R=1.390（95% CI ：1.130，1.710），P =0.002] 及心源性死亡[H^R=1.306（95% CI ：1.027，1.662），P =0.030] 事件的危险因素； Kaplan-Meier 生存曲线显示，高MPV 组不良心血管事件发生率更高，预后不佳（P <0.05）。结论 MPV 是 NSTEMI 患者PCI 术后不良预后的危险因素。

Abstract:

Objective To investigate the influence of mean platelet volume on long-term outcomes among patients with acute non-ST-segment elevation myocardial infarction after percutaneous coronary intervention. Methods A total of 885 NSTEMI patients underwent PCI in our hospital from January 2010 to October 2014 were selected. According to the baseline MPV values, 885 NSTEMI patients were divided into two groups: low MPV group (n = 756 MPV<10.94 fl) and high MPV group (n = 129 MPV ≥ 10.94 fl). Univariate and multivariate Cox regressions were established to analyze influence of MPV on the prognosis of such patients. Results After 30.9-month follow-up time, compared with low MPV group, the rates of all-cause mortality and cardiac mortality in high MPV group were higher. Multivariate analysis showed high MPV was a risk factor of all-cause mortality [Hl ^ R = 1.390, (95% CI: 1.130, 1.710), P = 0.002] and cardiac mortality [Hl ^ R = 1.306, (95% CI: 1.027, 1.662), P = 0.030]. The Kaplan-Meier survival curve showed high MPV group had the higher incidences of major adverse cardiac events. Conclusions MPV is an independent risk factor of poor prognosis after PCI for NSTEMI patients.