作　　者： (王洪敏）; (王毅）; (孙鑫新）; (吕静）; (周松）; (张朝霞）;

机构地区： 邢台市第一医院,邢台054001

出　　处： 《内科急危重症杂志》 2017年第4期309-311,共3页

摘　　要： 目的:探讨红细胞体积分布宽度(RDW)、血小板计数比值(PRP)与急性ST段抬高型心肌梗死(STEMI)行直接经皮冠状动脉介入治疗(PCI)患者心肌灌注水平的相关性。方法:选取108例STEMI并接受急诊PCI治疗的患者,根据术后TIMI心肌灌注分级,分为无复流组和正常血流组;比较2组患者的一般临床资料、术前血常规、心肌损伤标志物、术后即刻和30 d左室射血分数(LVEF)。结果:无复流组的平均年龄明显高于正常血流组(均P<0.05),无复流组的RDW、中性粒细胞百分比、RDW与血小板计数(PLT)比值、血浆B型钠尿肽(BNP)、高敏C反应蛋白(hs-CRP)以及D-dimer明显高于正常血流组(均P<0.05);无复流组PCI术后基线和PCI术后30 d的LVEF均明显低于正常血流组(P<0.05);多因素Logistic回归分析显示,RDW与PLT的比值(RPR)可作为提示STEMI患者行直接PCI术后无复流现象发生的独立预测指标(OR=8.306,95%CI=1.492~46.245,P=0.016)。结论:RPR可作为提示患者发生无复流的预测指标,应引起重视。 Objective： To explore and assess the correlation of red cell distribution width（ RDW） to platelet ratio and myocardial perfusion in patients with ST-segment elevation myocardial infarction（ STEMI） undergoing primary percutaneous coronary intervention. Methods： 108 patients diagnosed as having STEMI undergone primary percutaneous coronary intervention in our hospital from May 2014 to October 2016 were enrolled in this study and assigned to normal group and no-reflow group.Clinical characteristics,blood routine test,and markers of myocardial injury were compared. Besides,patients were subjected to echocardiography to check left ventricular ejection fraction at admission and 30 days after operation and data were compared as well. Results The average age of no-reflow group was significantly older than in the normal group（ P〈0. 05）.There were significant differences in RDW,NE%,RPR,BNP,hs-CRP,D-dimer and e GFR between no-reflow group and normal group（ P〈0. 05）. The LVEF at admission and 30 days after PCI in no-reflow group was significantly lower than in normal group（ P〈0. 05）. The logistic multivariate analysis revealed that RPR was an independent predictor factor for no-reflow in patients with STEMI undergoing primary PCI（ OR = 8. 306,95% CI = 1. 492-46. 245,P = 0. 016）. Conclusions：RDW to platelet ratio may be an independent predictor of no-reflow.

关 键 词： 红细胞体积分布宽度 急性 段抬高型心肌梗死 血小板计数 经皮冠状动脉介入治疗 无复流现象