心电图结合中性粒细胞/淋巴细胞比值对急性前壁心肌梗死患者PCI术后预后的预测价值

doi:10.7517/issn.1674-0475.200706

摘要/Abstract

摘要： 本文分析心电图结合中性粒细胞/淋巴细胞比值（NLR）对急性前壁心肌梗死患者PCI术后预后的预测价值。选取行PCI术的急性前壁AMI患者180例，观察其心电图和NLR水平变化，并应用Cox回归分析心电图变化、NLR水平高低与预后的相关性。180例患者不良心血管事件发生率为17.78%；NLR水平>3人数有113人；存在有室性期前收缩、房性期前收缩、碎裂QRS波、ST段抬高、ST段压低、QRS间期≥ 110 ms、QT离散度≥ 80 ms等心电图变化。NLR水平>3、室性期前收缩、碎裂QRS波、QRS间期≥ 110 ms、QT离散度≥ 80 ms等心电图变化是预测不良心血管事件发生的独立危险因素；心血管危险评分≥ 2分的不良心血管事件发生率明显低于心电图危险评分<2分的患者（P<0.05）。当入院时NLR水平为2.98时可获得最大Youden指数（0.36），其敏感度为88.54%，特异度为73.12%。当NLR>3或心电图危险评分≥ 2时，不良心血管事件的发生风险极大，对患者的预后具有一定的预测价值。

关键词: 心电图, PCI术, 急性前壁心肌梗死, 预测价值

Abstract: This paper analyzed the predictive value of electrocardiogram combined with neutrophil/lymphocyte ratio (NLR) on the prognosis of patients with acute anterior myocardial infarction after PCI. 180 patients with acute anterior wall AMI who underwent PCI were selected to observe the changes of ECG and NLR levels. Cox regression analysis was used to analyze the correlation between ECG changes, NLR levels and prognosis. The incidence of adverse cardiovascular events was 17.78% in 180 patients; 113 patients had NLR level >3; ECG changes such as ventricular premature beat, atrial premature beat, fragmented QRS complex, ST segment elevation, ST segment depression, QRS interval ≥ 110 ms, QT dispersion ≥ 80 ms and other ECG changes.NLR level >3, ventricular premature contraction, fragmented QRS complex, QRS interval ≥ 110 ms, QT dispersion ≥ 80 ms were predictive independent risk factors of adverse cardiovascular events.The incidence of adverse cardiovascular events in patients with cardiovascular risk score ≥ 2 was significantly lower than that in patients with ECG risk score <2 (P<0.05). The maximum Youden index (0.36) was obtained when the NLR level was 2.98 at admission, with a sensitivity of 88.54% and a specificity of 73.12%. When NLR >3 or ECG risk score ≥ 2, the risk of adverse cardiovascular events is great, which has a certain predictive value for the prognosis of patients.

Key words: electrocardiogram, PCI, acute anterior myocardial infarction, predictive value

李婕, 吕希俊, 汪宏. 心电图结合中性粒细胞/淋巴细胞比值对急性前壁心肌梗死患者PCI术后预后的预测价值[J]. 影像科学与光化学, 2021, 39(1): 91-95.

LI Jie, LYU Xijun, WANG Hong. Prognostic Value of Electrocardiogram Combined with Neutrophil/Lymphocyte Ratio in Patients with Acute Anterior Myocardial Infarction after PCI[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2021, 39(1): 91-95.

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