血小板参数与STEMI患者溶栓成功后LVEF的相关性

Correlation of Platelet Parameters with LVEF after Successful Thrombolysis in Patients with STEMI

摘要: 目的：分析血小板参数与急性ST段抬高型心肌梗死溶栓成功的患者左室射血分数的相关性。方法：选取2020年1月至2022年8月就诊于海南医学院第二附属医院心血管内科的急性ST段抬高型心肌梗死且溶栓成功的患者为研究对象，根据左室射血分数数值将患者分为左室射血分数下降组及对照组；单因素和多因素logistic回归模型分析影响左室射血分数下降的危险因素。受试者工作特征曲线(ROC)分析血小板参数对左室射血分数的预测价值。结果：1) 与对照组相比，左室射血分数下降组血小板分布宽度和血小板淋巴细胞比值差异有统计学意义(P < 0.05)。2) 多因素Logistic回归分析表明：血小板分布宽度和血小板淋巴细胞比值是左室射血分数下降的独立危险因素(P < 0.05)。3) ROC分析结果表明：血小板淋巴细胞比值预测左室射血分数下降患者的曲线下面积AUC为0.653 (95% CI: 0.565~0.740)，差异显著(P = 0.003 < 0.01)；当血小板淋巴细胞比值临界值是121.80，诊断左室射血分数下降的敏感性是93.60%，特异性是63.00%。结论：血小板分布宽度和血小板淋巴细胞比值是急性ST段抬高型心肌梗死溶栓成功后患者左室射血分数下降的独立预测因子；血小板淋巴细胞比值预测左室射血分数下降价值良好，且阈值为121.80时预测效果最优。

Abstract: Objective: The correlation between platelet parameters and left ventricular ejection fraction in pa-tients with successful thrombolysis in acute ST-segment elevation myocardial infarction was ana-lyzed. Methods: Patients with acute ST-segment elevation myocardial infarction and successful thrombolysis who visited the Department of Cardiology of the Second Affiliated Hospital of Hainan Medical College from January 2020 to August 2022 were selected as the research subjects, and the patients were divided into the left ventricular ejection fraction decreased group and the control group according to the left ventricular ejection fraction value. Univariate and multivariate logistic regression models analyze risk factors affecting decreased left ventricular ejection fraction. The re-ceiver operating characteristic curve (ROC) analyzes the predictive value of platelet parameters for left ventricular ejection fraction. Results: 1) Compared with the control group, the difference in platelet distribution width and platelet lymphocyte ratio in the group with decreased left ventricu-lar ejection fraction was statistically significant (P < 0.05). 2) Multivariate logistic regression analy-sis showed that platelet distribution width and platelet-lymphocyte ratio were independent risk factors for decreased left ventricular ejection fraction (P < 0.05). 3) The results of ROC analysis showed that the AUC under the curve in which platelet-lymphocyte ratio predicted left ventricular ejection fraction was 0.653 (95% CI: 0.565~0.740), and the difference was significant (P = 0.003 < 0.01); When the platelet-lymphocyte ratio cut-off is 121.80, the sensitivity for diagnosing decreased left ventricular ejection fraction is 93.60%, and the specificity is 63.00%. Conclusion: Platelet dis-tribution width and platelet-lymphocyte ratio were independent predictors of the decline of left ventricular ejection fraction in patients with acute ST-segment elevation myocardial infarction after successful thrombolysis. Platelet-lymphocyte ratio predicts a decrease in left ventricular ejection fraction with a good value, and the predictive effect is best when the threshold is 121.80.