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目的研究血小板分布宽度(platelet distribution width,PDW)与急性冠状动脉综合征(acute coronary syndrome,ACS)患者30 d内发生不良心血管事件的关系,为ACS患者危险度分层提供新的参考指标。方法选取2011年1月至2015年1月入住心内科的ACS患者130例。所有患者入院后检测各项生化指标,将ACS组患者按PDW检测结果分为高PDW组(PDW≥16.7%,n=64)和低PDW组(PDW<16.7%,n=66),比较组间30 d内主要不良心血管事件发生情况,包括:心源性死亡、心力衰竭、再发心肌梗死、恶性心律失常、顽固性心绞痛。同时按照30 d内有无不良心血管事件发生将ACS患者分为事件组(n=76)和非事件组(n=54),作不良心血管事件影响因素的单因素分析,并进一步行多因素Logistic回归分析。结果 (1)事件组的PDW值较非事件组明显增高[(16.98±0.66)%vs(15.16±0.49)%,P<0.05]。(2)ACS患者中高PDW组住院期间主要不良心血管事件的总发生率较低PDW组明显增加(84.3%vs 33.3%,P<0.01)。(3)多因素Logistic回归分析显示,PDW(OR=3.775,95%CI:1.111~11.988,P<0.05)、超敏C反应蛋白(hs-CRP)和B型利钠肽(BNP)水平增高是影响主要不良心血管事件的独立危险因素。结论 ACS组患者外周血PDW水平显著增高,PDW或可作为ACS患者短期预后的独立预测因素。
Objective To investigate the relationship between platelet distribution width (PDW) and adverse cardiovascular events within 30 days in patients with acute coronary syndrome (ACS), and provide new reference indexes for risk stratification in patients with ACS. Methods One hundred and thirty ACS patients admitted to Department of Cardiology between January 2011 and January 2015 were enrolled. All patients were admitted to hospital for detection of biochemical markers. According to the results of PDW, ACS patients were divided into high PDW group (PDW≥16.7%, n = 64) and low PDW group (PDW <16.7%, n = 66) Major adverse cardiovascular events within 30 days, including: cardiac death, heart failure, recurrent myocardial infarction, malignant arrhythmias, refractory angina. At the same time, ACS patients were divided into event group (n = 76) and non-event group (n = 54) according to the incidence of adverse cardiovascular events within 30 days. Univariate analysis was used to analyze the influencing factors of adverse cardiovascular events. Logistic regression analysis. Results (1) The PDW of the event group was significantly higher than that of the non-event group [(16.98 ± 0.66)% vs (15.16 ± 0.49)%, P <0.05]. (2) The incidence of major adverse cardiovascular events in hospitalized patients with high PDW in ACS group was significantly higher than that in the lower PDW group (84.3% vs 33.3%, P <0.01). (3) Multivariate logistic regression analysis showed that the levels of hs-CRP and BNP were significantly increased in PDW group (OR = 3.775,95% CI: 1.111-11.988, P <0.05) Is an independent risk factor affecting major adverse cardiovascular events. Conclusion PDW levels in peripheral blood of patients with ACS are significantly higher than those in patients with ACS. PDW may be an independent predictor of short-term prognosis in patients with ACS.