PLR联合CHA<sub>2</sub>DS<sub>2</sub>-VASc评分对STEMI患者PCI术后发生无复流的预测价值

doi:10.3969/j.issn.1671-7171.2025.06.010

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摘要【目的】探讨血小板/淋巴细胞比值(PLR)与CHA₂DS₂-VASc评分联合预测ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入术(PCI)后无复流的价值。【方法】分析136例行PCI的STEMI患者,根据术后有无复流的发生进行分组,采用二元Logistic回归分析PCI术后患者发生无复流的影响因素,通过受试者工作特征(ROC)曲线分析PLR与CHA₂DS₂-VASc评分对PCI患者术后发生无复流的预测价值。【结果】 136例患者中PCI术后有31例出现无复流现象(无复流组),发生率为21.23%;其余105例患者未出现无复流(复流组)。无复流组术前收缩压、舒张压、白细胞介素-6、支架总长度、PLR及CHA₂DS₂-VASc评分均高于复流组(P<0.05)。Logistic回归分析显示,支架总长度、PLR及CHA₂DS₂-VASc评分均为影响患者术后无复流发生的危险因素。ROC曲线分析结果显示,PLR、CHA₂DS₂-VASc评分联合预测患者术后无复流发生的特异度、曲线下面积明显高于两者单独检测(均P<0.05)。【结论】 PLR联合CHA₂DS₂-VASc评分预测STEMI患者PCI术后无复流的发生具有较高的预测效能,可以作为评估患者术后无复流发生风险的重要参考依据。

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	陶守建
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关键词 ： ST段抬高型心肌梗死, 血管成形术,气囊,冠状动脉, 比值比, 淋巴细胞, 中性白细胞, 无复流现象

Abstract：【Objective】 To explore the predictive value of the platelet-to-lymphocyte ratio (PLR) combined with the CHA₂DS₂-VASc score for the no-reflow phenomenon after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI).【Methods】A total of 136 STEMI patients who underwent PCI were analyzed. According to the occurrence of the no-reflow phenomenon postoperatively, the patients were divided into groups. Binary logistic regression analysis was used to identify the influencing factors of reflow or no-reflow after PCI. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive value of PLR and CHA₂DS₂-VASc score for postoperative no-reflow.【Results】 Among the 136 patients, 31 cases (21.23%) developed the no-reflow phenomenon after PCI (no-reflow group), while the remaining 105 cases did not (reflow group). Preoperative systolic and diastolic blood pressure, interleukin-6, total stent length, PLR, and CHA₂DS₂-VASc score were all significantly higher in the no-reflow group compared to the reflow group (P<0.05). Logistic regression analysis showed that total stent length, PLR, and CHA₂DS₂-VASc score were risk factors for postoperative no-reflow. ROC curve analysis indicated that the combination of PLR and CHA₂DS₂-VASc score had a significantly higher area under the curve and specificity for predicting no-reflow after PCI compared to either parameter alone (P<0.05).【Conclusion】 The combination of PLR and CHA₂DS₂-VASc score has a high predictive value for the occurrence of no-reflow in STEMI patients after PCI and can serve as an important reference for evaluating postoperative no-reflow risk.

Key words： ST Elevation Myocardial Infarction Angioplasty, Balloon, Coronary Odds Ratio Lymphocytes Neutrophils No-Reflow Phenomenon

收稿日期: 2024-09-14

中图分类号:

R542.22

引用本文:

陶守建, 贾蓓. PLR联合CHA₂DS₂-VASc评分对STEMI患者PCI术后发生无复流的预测价值[J]. 医学临床研究, 2025, 42(6): 944-946.
TAO Shoujian, JIA Bei. Predictive Value of PLR Combined with CHA₂DS₂-VASc Score for No-Reflow Phenomenon after PCI in STEMI Patients. JOURNAL OF CLINICAL RESEARCH, 2025, 42(6): 944-946.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.06.010 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I6/944

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