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目的探讨中性粒细胞/淋巴细胞比值(NLR)与ST段抬高的心肌梗塞(STEMI)患者经皮穿刺冠脉介入治疗(PCI)后心室重构(VR)的关系。方法连续回顾327例STEMI行PCI的患者,入院和24 h后采集血液标本并检测WBC、中性粒细胞(N)、淋巴细胞(L)、血红蛋白(Hb)和其他包括CK-MB质量的生化指标。入院和心梗后6个月检测心电图。按有无VR将患者分为2组:VR组(87例)和非VR组(240例)。结果与非VR组比较,VR组患者NLR、峰值CK-MB显著较高,差异有统计学意义(P<0.05)。多因素回归分析发现,NLR升高为STEMI患者PCI术后发生VR的独立风险因素(OR=1.836,95%CI:1.425~4.239,P<0.01)。结论 NLR是STEMI患者PCI术后发生心室重构等不良心血管事件有用的预测指标,临床应加强对基础NLR升高患者的管理。
Objective To investigate the relationship between neutrophil / lymphocyte ratio (NLR) and ventricular remodeling (VR) after percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). Methods A total of 327 STEMI patients undergoing PCI were retrospectively reviewed. Blood samples were taken at admission and 24 h later. WBC, neutrophils (N), lymphocytes (L), hemoglobin (Hb) and other biochemical markers including CK-MB index. 6 months after admission and myocardial infarction ECG. The patients were divided into two groups according to the presence or absence of VR: VR group (87 cases) and non-VR group (240 cases). Results Compared with non-VR group, NLR and peak CK-MB in VR group were significantly higher (P <0.05). Multivariate regression analysis showed that increased NLR was an independent risk factor for VR after STEMI (OR = 1.836, 95% CI: 1.425-4.239, P <0.01). Conclusion NLR is a useful predictor of adverse cardiovascular events such as ventricular remodeling after PCI in patients with STEMI. The management of patients with elevated basal NLR should be strengthened in clinical practice.