急性心肌梗死时早期心力衰竭与中性粒细胞的关系

Association between Congestive Heart Failure and Neutrophilia after Acute Myocardial Infarction

目的 为了探索急性心肌梗死 (AMI)后早期充血性心力衰竭 (CHF)的出现是否与外周血白细胞有关 ,以及有关的影响因素 ,为CHF出现提供预测。方法 回顾性分析 1994年 1月至 2 0 0 4年 4月期间 2 14例AMI病人入院时白细胞总数及分类计数 ,入院 4d内临床诊断的CHF ,及病人有关病史及治疗措施。对各种因素进行逐步回归 ,以分析与CHF的关系。结果 CHF与中性粒细胞显著相关 ,当中性粒细胞数≥ 80 0 0个 /mm3 时 ,CHF发生增加 3倍 (P <0 0 0 1)。结论 中性粒细胞数是急性心肌梗死时早期心力衰竭发生最显著的独立预测因素。

Objectives This study was to examine the association between hospital admission peripheral total leukocyte and the neutrophil count and subsequent development of congestive heart failure (CHF) in patients with acute myocardial infarction (AMI). Methods and results This was a retrospective cohort study in thes etting of a teaching hospital. Participants included 214 patients discharged with a diagnosis of AMI between January 1994 and April 2004. CHF was diagnosed based on clinical symptoms. Multivariable stepwise regressionan alyses were performed to examine the relation between the total leukocyte count, nentrophil percentage, and development of CHF in first 4 days after AMI while controlling for baseline characteristics and early therapeutic interventions. A highly significant association between neutrophilia and the subsequent development of CHF: existed. 64.2% of the patients with neutrophi >8 000 counts/mm 3 had CHF (odds ratio 3.10; P<0.001).Conclusions Neutrophilia on admission to hospital in patients with AMI is significantly associated with early development of CHF