摘要【目的】探讨中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)联合血肌酐和射血分数评分预测急性ST段抬高型心肌梗死(STEMI)经皮冠状动脉介入术(PCI)后主要心脏不良事件(MACE)发生的价值。【方法】测定85例行PCI治疗的STEMI患者术后24 h的NLR、PLR、血肌酐、射血分数评分,根据患者术后1年内是否发生MACE分成发生组与未发生组,分析发生MACE的相关因素及评估术后24 h NLR、PLR、血肌酐、射血分数评分及四者联合对发生MACE的预测效能。【结果】随访1年,85例STEMI术后患者发生MACE 19例,发生率为22.35%,66例患者(77.65%)未发生MACE。发生组患者年龄、置入支架长度、术后24 h白细胞计数、超敏C反应蛋白、 NLR、PLR、血肌酐、射血分数评分高于未发生组(P<0.05);Logistic多因素回归分析结果显示,年龄,术后24 h NLR、PLR、血肌酐、射血分数评分为STEMI患者术后1年内发生MACE的影响因素(P<0.05);受试者工作特征(ROC)曲线结果显示,术后24 h NLR、PLR、血肌酐、射血分数评分及四者联合预测发生MACE的曲线下面积(AUC)值分别为0.791、0.802、0.821、0.813和0.892,联合预测效能均高于单一预测(P<0.05)。【结论】术后24 h NLR、PLR、血肌酐联合射血分数评分可用于STEMI患者PCI术后1年内发生MACE的预测,且四者联合具有更高的预测效能。
Abstract：【Objective】To investigate the value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) combined with serum creatinine and ejection fraction score in predicting major adverse cardiac events (MACE) after percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI).【Methods】 NLR, PLR, serum creatinine, and ejection fraction score were measured 24 hours postoperatively in 85 STEMI patients who underwent PCI. Patients were divided into the MACE occurrence group and the MACE non-occurrence group based on whether they experienced MACE within one year postoperatively. The relevant factors associated with MACE and the predictive efficacy of NLR, PLR, serum creatinine, ejection fraction score, and their combination in predicting MACE were analyzed. 【Results】After a one-year follow-up, 19 out of 85 STEMI patients experienced MACE, with an incidence rate of 22.35%, while 66 patients (77.65%) did not. Patients in the MACE occurrence group had significantly higher age, stent length, postoperative 24-hour white blood cell count, high-sensitivity C-reactive protein (hs-CRP), NLR, PLR, serum creatinine, and ejection fraction score compared to the MACE non-occurrence group (P<0.05). Logistic multivariate regression analysis showed that age, postoperative 24-hour NLR, PLR, serum creatinine, and ejection fraction score were influencing factors for MACE occurrence within one year in STEMI patients (P<0.05). The receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) values for predicting MACE occurrence using postoperative 24-hour NLR, PLR, serum creatinine, ejection fraction score, and their combination were 0.791, 0.802, 0.821, 0.813, and 0.892, respectively, with the combined prediction showing superior efficacy compared to individual predictors (P<0.05). 【Conclusion】 Postoperative 24-hour NLR, PLR, and serum creatinine combined with the ejection fraction score can be used to predict and assess MACE occurrence within one year after PCI in STEMI patients, with their combined use demonstrating higher predictive efficacy.
李渊. NLR、PLR联合血肌酐和射血分数评分预测STEMI经皮冠状动脉介入术后MACE事件的价值[J]. 医学临床研究, 2025, 42(5): 795-798.
LI Yuan. Value of NLR, PLR Combined with Serum Creatinine and Ejection Fraction Score in Predicting MACE Events after PCI in STEMI Patients. JOURNAL OF CLINICAL RESEARCH, 2025, 42(5): 795-798.
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2025, Vol. 42 
