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平均血小板体积与老年非ST段抬高型急性冠脉综合征患者的严重冠脉病变的相关性研究

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目的 研究平均血小板体积(MPV)对老年非ST段抬高型急性冠脉综合征(NSTE-ACS)
患者的严重冠状动脉(冠脉)病变的预测价值。方法 连续纳入自2016年8月至2018年9月于解放军总医
院第六医学中心干部病房心血管内科行经皮腔内冠脉介入治疗的102例NSTE-ACS老年患者。收集患者的
基本信息、实验室检验结果和冠脉造影结果。根据MPV水平,使用三分位法将患者分为3组:组1:MPV
≤9.8 fl(36例),组2:MPV 9.9~10.8 fl(38例),组3:MPV≥10.9 fl(28例)。严重冠脉病变定义为三
支病变和(或)左主干病变。结果 MPV高组别老年患者中,低密度脂蛋白、高敏性C反应蛋白、GRACE
评分和严重冠心病患者的比例高于其他组别,差异有统计学意义(P均<0.05)。多因素回归分析表
明,吸烟(OR=3.21,95%CI:1.415~7.28,P=0.005),高血压病(OR=11.919,95%CI:2.617~54.291,
P=0.001),糖尿病(OR=4.364,95%CI:1.866~10.203,P=0.001),MPV(OR=5.748,95%CI:
1.822~18.139,P=0.003)是老年NSTE-ACS患者严重冠脉病变的独立危险因素。结论 MPV是老年NSTEACS
患者的严重冠脉病变的一个独立危险因素。

Abstract:

Objective To study the predictive value of mean platelet volume (MPV) to severe coronary artery
lesions in elderly patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS). Methods The
elderly NSTE-ACS patients (n=102) undergone percutaneous coronary intervention (PCI) were continuously chosen
from Department of Cardiovascular Medicine of Ward of Geriatrics in the Sixth Medical Center of Chinese PLA
General Hospital from Aug. 2016 to Sept. 2018. The basic data, outcomes of laboratory examinations and results
of coronary angiography were collected from the patients. All patients were divided, according to MPV level, into
group 1 (MPV≤9.8 fl, n=36), group 2 (MPV=9.9-10.8 fl, n=38) and group 3 (MPV≥10.9 fl, n=28). The severe
coronary artery lesions were defined as 3-vessel lesions and/or lesion of left main coronary artery (LMCA). Results
The scores of low-density lipoprotein (LDL), high-sensitivity C-reactive protein (hs-CRP), GRACE integrals and
percentage of patients with severe coronary artery lesions were higher in groups with higher MPV level than those in
other groups (all P<0.05). The results of multi-factor regression analysis showed that smoking (OR=3.21, 95%CI:
1.415~7.28, P=0.005), hypertension (OR=11.919, 95%CI: 2.617-54.291, P=0.001), diabetes (OR=4.364, 95%CI:
1.866~10.203, P=0.001) and MPV (OR=5.748, 95%CI: 1.822-18.139, P=0.003) were independent risk factors of
severe coronary artery lesions in elderly NSTE-ACS patients. Conclusion MPV is an independent risk factor of
severe coronary artery lesions in elderly NSTE-ACS patients.

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参考文献:

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