平均血小板体积对急性冠脉综合征患者在院风险评估以及预后预测的意义

发布时间：2018-11-27 18:52

【摘要】：目的1验证MPV在急性冠脉综合征诊断中的作用,确定是否不同类型的急性冠脉综合征患者其MPV值不同。2了解MPV和急性冠脉综合征患者的在院风险之间的关系,是否高风险患者其MPV值更大。3预测影响急性冠脉综合征患者sT段抬高的危险因素,确定MPV是否是其危险因素。4判断是否MPV值在预测急性冠脉综合征患者的预后中具有重要意义。材料和方法收集2014年安徽省立医院心内科收住的符合要求的急性冠脉综合征的病人的MPV,空腹血糖,LDL-C,血小板数目,入院时GRACE评分和出院时GRAVE等数据。1 将所有患者分成ST段抬高组和非ST段抬高组,分析两组间MPV值是否有统计学差异。2 按入院时GRACE评分将患者分成高危组和非高危组,分析两组之间MPV的差异有无统计学意义。同样按出院时GRACE评分分组并分析两组之间MPV的差异。3 通过以空腹血糖,MPV,血小板数目,血尿酸,血LDL-C和年龄为自变量,是否有ST段抬高为因变量进行回归分析最终明确影响急性冠脉综合征患者ST段抬高的危险因素。结果所有收集的病例资料共235例,其中ST段抬高组101例,非sT段抬高组134例,两组之间的性别、血糖、血尿酸和血LDL-C均无统计学差异,而年龄(p=0.005),血小板数目(p=0.007)和MPV差异较明显,其中ST段抬高组MPV值比非ST段抬高组高(p=0.000)；入院时GRACE评分高危组较非高危组的MPV升高明显(p=0.002),亚组中低危组和中危组之间的MPV无明显统计学差异(p=0.124)。出院时GRACE评分高危组的MPV较非高危组也明显升高(p=0.009),而中危组和低危组之间差异亦无统计学意义(p=0.857)。Logistic回归显示年龄(p=0.016,OR[95%CI]=1.033[1.006-1.106])和MPV(p=0.000,OR[95%CI]=2.857[2.082-3.920])是影响急性冠脉综合征患者ST段抬高的独立危险因素,而性别(p=0.479)、空腹血糖(p=0.746)、血LDL-C(p=0.091)、血尿酸(p=0.950)以及血小板数目(p=0.257)则不是。结论1 MPV和急性冠脉综合征诊断关系密切,尤其是对ST段抬高的急性冠脉综合征患者,其MPV明显升高。2无论是入院时高危患者还是出院时高危患者,其MPV都显著高于中低危患者,中低危患者之间的MPV无明显统计学差异。3年龄和MPV是影响急性冠脉综合征患者ST段抬高的危险因素。4 以GRACE评分为桥梁判断,MPV对急性冠脉综合征患者的诊断以及短期预后预测具有重要意义。
[Abstract]:Objective 1 to verify the role of MPV in the diagnosis of acute coronary syndrome (ACS) and determine whether different types of ACS patients have different MPV values. 2 to understand the relationship between MPV and the hospital risk of ACS patients. Whether high risk patients had higher MPV levels. 3 predicted risk factors for sT segment elevation in patients with acute coronary syndrome. To determine whether MPV is a risk factor. 4 to determine whether the MPV value is important in predicting the prognosis of patients with acute coronary syndrome (ACS). Materials and methods MPV, fasting blood glucose and LDL-C, platelets were collected from patients in the Department of Cardiology, Anhui Provincial Hospital in 2014, who met the requirements of acute coronary syndrome (ACS). Data of GRACE score on admission and GRAVE on discharge. 1 all patients were divided into ST segment elevation group and non ST segment elevation group, and the difference of MPV value between the two groups was analyzed. 2 according to the GRACE score at admission, the patients were divided into high risk group and non high risk group. The difference of MPV between the two groups was analyzed. The differences of MPV between the two groups were also analyzed according to the GRACE score at discharge. 3 by using fasting blood glucose, the number of MPV, platelets, serum uric acid, serum LDL-C and age as independent variables, Regression analysis was conducted to determine the risk factors of ST segment elevation in patients with acute coronary syndrome (ACS). Results 235 cases were collected, including 101 cases of ST segment elevation group and 134 cases of non-sT segment elevation group. There was no significant difference in sex, blood glucose, serum uric acid and serum LDL-C between the two groups (p 0.005). The number of platelet (p0. 007) and MPV were significantly different. The MPV value of ST segment elevation group was higher than that of non ST segment elevation group (p0. 000). At admission, the GRACE score in the high risk group was significantly higher than that in the non high risk group (p0. 002), but there was no significant difference in MPV between the low and middle risk groups in the subgroup (p0. 124). MPV in high risk group was significantly higher than that in non high risk group at discharge (p0. 009), but there was no significant difference between middle risk group and low risk group (p0. 857). Logistic regression showed age (p0. 016). OR [95%CI] = 1.033 [1.006-1.106] and MPV (p0.000OR [95%CI] = 2.857 [2.082-3.920]) were independent risk factors for ST segment elevation in patients with acute coronary syndrome. Sex (p0. 479), fasting blood glucose (p0. 746), serum LDL-C (p0. 091), serum uric acid (p0. 950) and platelet count (p0. 257) were not. Conclusion (1) MPV is closely related to the diagnosis of acute coronary syndrome, especially in patients with acute coronary syndrome with elevated ST segment. (2) MPV is significantly higher in patients with acute coronary syndrome (ACS) than in patients with acute coronary syndromes (ACS) at admission and discharge. There was no significant difference in MPV between middle and low risk patients. Age and MPV were the risk factors influencing ST segment elevation in patients with acute coronary syndrome. 4 the GRACE score was used as a bridge to judge. MPV plays an important role in the diagnosis and short-term prognosis of patients with acute coronary syndrome.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R541.4

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