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目的：探讨血流储备分数（FFR）及血小板与总胆红素比值（PLT/TBIL）、平均血小板体积与血小板计数比值（MPV/PC）与冠心病经皮冠状动脉介入（PCI）术后主要不良心血管事件（MACE）的关系，为临床预防MACE发生提供参考。方法：选取2020年1月至2023年1月南京中医药大学江阴附属医院收治的230例行PCI术治疗冠心病患者相关资料实施回顾性研究，按术后1年MACE发生情况分为MACE组（n=52），与非MACE组（n=178）。PCI术后MACE发生的影响因素采用二元Logistic回归分析，各项指标对冠心病PCI术后MACE发生的预测效能采用受试者工作特征曲线（ROC）分析。结果：单因素分析显示，两组病变血管支数、NYHA心功能分级、FFR、PLT/TBIL、MPV/PC比较均有差异（P<0.05）。二元Logistic回归分析显示，病变血管支数(三支病变)、NYHA心功能分级(Ⅳ级)、PLT/TBIL、MPV/PC均为冠心病PCI术后MACE发生影响因素，而FFR是保护因素（P<0.05）。ROC曲线分析显示，FFR、PLT/TBIL、MPV/PC单独预测冠心病PCI术后MACE发生的曲线下面积（AUC）分别为0.744、0.703、0.771；而FFR、PLT/TBIL、MPV/PC联合预测冠心病PCI术后MACE发生的AUC为0.823，预测效能显著提升。结论：FFR、PLT/TBIL、MPV/PC与冠心病PCI术后MACE发生相关密切，可作为预测冠心病PCI术后MACE发生有效指标，且联合预测的价值更高。

英文摘要:

Objective: To investigate the relationship between fractional flow reserve (FFR), platelet to total bilirubin ratio (PLT/TBIL),mean platelet volume to platelet count ratio (MPV/PC) and major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with coronary heart disease, and to provide reference for clinical prevention of MACE.Methods:The data of 230 patients with coronary heart disease who underwent PCI in Jiangyin Affiliated Hospital of Nanjing University of Chinese Medicine from January 2020 to January 2023 were retrospectively studied.According to the occurrence of MACE 1 year after operation, they were divided into MACE group (n=52) and non-MACE group (n=178).The influencing factors of MACE after PCI were analyzed by binary Logistic regression analysis, and the predictive efficacy of each index on MACE after PCI for coronary heart disease was analyzed by receiver operating characteristic curve (ROC).Results:Univariate analysis showed that there were differences in the number of diseased vessels, NYHA cardiac function classification, FFR, PLT / TBIL, MPV / PC between the two groups (P<0.05). Binary Logistic regression analysis showed that the number of diseased vessels (three-vessel lesion), NYHA cardiac function classification (IV), PLT/TBIL, MPV/PC were all influencing factors of MACE after PCI for coronary heart disease, while FFR was a protective factor (P<0.05).ROC curve analysis showed that the area under the curve (AUC) of FFR, PLT/TBIL and MPV/PC in predicting the occurrence of MACE after PCI for coronary heart disease were 0.744, 0.703 and 0.771, respectively.The AUC of FFR, PLT / TBIL, MPV / PC jointed to predict the occurrence of MACE after PCI in coronary heart disease was 0.823, and the predictive efficacy was significantly improved.Conclusion:FFR,PLT/TBIL, MPV/PC are closely related to the occurrence of MACE after PCI in coronary heart disease, which can be used as an effective index to predict the occurrence of MACE after PCI in coronary heart disease, and the value of combined prediction is higher.

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