The Sudy On The Predictive Value Of Leukocyte NLR Value For Short-term Prognosis Of Patients With Acute Myocardial Infarction After PCI And The Correlation Of TCM Syndrome Types

Objectiveto analyze the predictive value of neutrophil to lymphocyte ratio(NLR)in the short-term prognosis of patients with acute myocardial infarction after PCI.Combined with other risk factors,the probability of major adverse cardiovascular events(MACE)in patients with acute myocardial infarction after PCI was predicted.Objective to analyze the correlation between NLR value and TCM syndrome types,so as to guide the clinical early intervention of TCM.MethodsThis study collected the laboratory examination results of 245 inpatients with acute myocardial infarction who had undergone emergency PCI stent implantation in the First Affiliated Hospital of Guangzhou University of traditional Chinese medicine from January2019 to June 2020.According to whether the patients had major adverse cardiovascular events(MACE)during hospitalization,the patients were divided into MACE group and non MACE group,in order to evaluate the correlation between neutrophil lymphocyte ratio(NLR)and adverse cardiovascular events(MACE).ROC curve was used to analyze NLR and WBC,and their specificity and sensitivity were compared.The logistic multivariate regression was used to analyze NLR and other laboratory indexes with statistical significance,and the independent risk factors of MACE were screened out,and the regression model was established.the correlation between NLR and TCM syndrome type was analyzed in order to guide the clinical early intervention of traditional Chinese medicine.Results1.General data comparison: 245 patients were divided into MACE group(89 cases)and non MACE group(156 cases).Compared with non MACE group,there were more smoking(64%)and older(64.18 ± 12.893 years old)women(29.2%)in MACE group(P <0.05).2.ROC curve analysis of WBC,NLR and MACE: the area under the ROC curve of WBC in predicting MACE was 0.769;the area under the ROC curve of NLR in predicting MACE was 0.911,the best cut-off value was 3.4064,the sensitivity was 93.3%,and the specificity was 76.3%.The area difference under ROC curve of WBC and NLR in predicting MACE was 0.142(P < 0.05).According to the best cut-off value of NLR,NLR data are divided into high value data and low value data.3.Comparison of biochemical indexes: the biochemical indexes of MACE group and non MACE group were compared.The results showed that CRP,FIC,D-dimer,LDL-C,CHOL,CTn I of MACE group were higher than those of non MACE group,and the difference was statistically significant(P < 0.05).4.Construction of prediction model: a total of 245 patients were included in this study,including 171 patients in the modeling group and 74 patients in the verification group.After multivariate logistic regression analysis,NLR,CRP,cholesterol,gender,smoking and D-dimer were used as predictors to construct the prediction model.The AUC of discrimination evaluation index was 0.960 and 0.935 respectively;the repeatability of standard curve and calibration curve was high in modeling group and validation group.At the same time,Hosmer lemeshow test(goodness of fit test)showed that the modeling group P = 0.966 > 0.05,the validation group P = 0.461 > 0.05.5.TCM syndrome analysis: in MACE group,heat toxin and blood stasis syndrome was the most common,followed by phlegm and blood stasis syndrome,Qi deficiency and blood stasis syndrome.High NLR value was correlated with heat toxin and blood stasis syndrome(P < 0.05).There was a close relationship between female patients and heart kidney yang deficiency syndrome,Qi deficiency and blood stasis syndrome(P < 0.05).Conclusions1.The blood NLR of MACE group was significantly higher than that of non MACE group,NLR was an independent risk factor of MACE in patients with acute myocardial infarction after PCI;when NLR > 3.4064,it had high diagnostic value for MACE.2.Smoking history,gender,CRP,cholesterol and D-dimer are also independent risk factors for MACE in patients with acute myocardial infarction after PCI,and a clinical prediction model for short-term prognosis of patients with acute myocardial infarction after PCI was constructed.3.In MACE group,heat toxin and blood stasis syndrome was the most common,followed by phlegm and blood stasis syndrome,Qi deficiency and blood stasis syndrome.Patients with high NLR value are closely related to heat toxin and blood stasis syndrome.