论文部分内容阅读
目的监测血小板分布宽度(PDW)、平均血小板体积(MPV)、血小板计数(PLT)水平变化对急性心肌梗死(AMI)患者1年内主要不良心脏事件(MACE)的预测价值,为AMI患者预后质量的评估提供参考依据。方法选取解放军第309医院2013年6月-2015年6月收治的117例AMI患者为观察组,并选取同期80名健康体检者作为对照组,比较两组受试者PDW、MPV、PLT等血小板参数差异。对AMI患者实施1年随访,记录其随访期间MACE发生情况,并按照MACE发生情况,分别纳入发生MACE组、未发生MACE组,比较两组患者血小板参数差异,分析血小板参数预测MACE发生的价值。结果观察组治疗前、治疗后3 d PDW、MPV高于对照组,其PLT低于对照组,差异有统计学意义(P<0.05)。两组受试者治疗后7 d血小板参数比较,差异无统计学意义(P>0.05)。随访期间39例患者发生MACE,发生率为33.33%。发生MACE组术前PDW、MPV高于未发生MACE组,其PLT低于后者,差异有统计学意义(P<0.05);两组患者治疗后7 d PDW、MPV均较治疗前下降,PLT均较治疗前升高,未发生MACE组改善更为明显,差异有统计学意义(P<0.05)。ROC曲线示,治疗前、治疗后7 d PDW、MPV、PLT对预测患者1年内MACE发生风险均具有较高价值(P<0.05)。结论血小板分布宽度、体积增加及计数减少可能与AMI发生发展及预后变化具有密切关联,密切监测治疗前后血小板参数可有效预测患者1年内MACE发生风险,指导临床诊治。
Objective To investigate the predictive value of the change of platelet distribution width (PDW), mean platelet volume (MPV) and platelet count (PLT) in major adverse cardiac events (MACE) within 1 year in patients with acute myocardial infarction (AMI) Evaluation provides a reference. Methods A total of 117 patients with AMI who were admitted to the 309th Hospital of PLA from June 2013 to June 2015 were selected as the observation group and 80 healthy subjects were selected as the control group. The PDW, MPV, PLT and other platelets were compared between two groups Parameter differences. The patients with AMI were followed up for one year. The incidence of MACE during follow-up was recorded. According to the occurrence of MACE, MACE was included in the group without MACE. The difference of platelet parameters was compared between the two groups. The platelet parameters were analyzed to predict the value of MACE. Results Before treatment, the PDW and MPV in the observation group were higher than those in the control group 3 days after treatment, and the PLT in the observation group was lower than that in the control group (P <0.05). There was no significant difference in platelet parameters between the two groups on the 7th day after treatment (P> 0.05). During follow-up, 39 patients had MACE, the incidence was 33.33%. The occurrence of preoperative PDE in MACE group was higher than that in non-MACE group, and the PLT was lower than the latter group (P <0.05). PDW and MPV in both groups decreased 7 days after treatment, PLT Were higher than before treatment, MACE group did not improve the more obvious, the difference was statistically significant (P <0.05). The ROC curve showed that PDW, MPV and PLT had higher value of predicting MACE risk within 1 year before treatment and 7 days after treatment (P <0.05). Conclusion The distribution of platelet width, volume increase and decrease of count may be closely related to the development and prognosis of AMI. To monitor the platelet parameters before and after treatment can effectively predict the risk of MACE within 1 year and guide the clinical diagnosis and treatment.