外周血白细胞计数及C反应蛋白对冠心病的危险性评估

Evaluation on white cell count in peripheral blood and plasma C-reactive protein for risk of coronary heart disease

目的探讨C反应蛋白(CRP)、外周血白细胞计数(WBC)及中性粒细胞计数(PMN)对冠心病危险性的评估。方法检测68例急性冠脉综合征(ACS)、28例稳定性心绞痛(SA)及33例对照者CRP、WBC及PMN,按冠状动脉狭窄支数进行分组,研究冠脉狭窄范围与上述三指标的关系。结果ACS组CRP、WBC及PMN与SA组及对照组比较,差异显著(P<0.01);急性心肌梗死(AMI)组三指标均显著高于不稳定心绞痛(UA)组、SA组及对照组(P<0.01),UA组CRP水平显著高于SA组及对照组(P<0.01);CRP在冠脉狭窄1支、2支、多支之间比较,差异有显著性(P<0.05);WBC≥10×109/L比白细胞<10×109/L者发生心力衰竭的可能性明显增高,OR=3.462,P<0.05,95%CI(1.135,10.556)。结论血浆CRP、外周血WBC与PMN对于评估冠心病的危险性有重要意义,白细胞计数升高是冠心病发生心力衰竭的高危险因素。

Objective To evaluate CRP, peripheral WBC and neutrophil for the risk of coronary heart disease. Methods Plasma CRP levels,peripheral WBC and neutrophll count of 68 acute coronary syndrome（ACS） patients,28 stable angina（SA） patients and 33 controls were measured. Results There were significant differences of CRP levels ,peripheral WBC and neutrophil count between the ACS group and the SA group or control group;CRP levels, peripheral WBC and neutrophil count in acute myocardial infarction （AMI） patients were much higher than those in unstahle angina（UA） patients,SA patients and controls（ P 〈 0.01 ）. CRP levels in UA patients were much higher than those in SA patients and 6ontrols（P 〈0.01 ）. CRP levels in mono-vessel coronary stenosis were different from bi-or muhivessel coronary stenosis（P 〈 0.05 ）. The patients with more than 10 ×10^9/L of WBC were mnre likely to develop congestive heart failure（CHF） than the patients with less than 10 ×10^9/L of WBC（ odds ratio 3. 462 ,P 〈 0. 05,95% CI 1. 135-10. 556）. Conclusion Plasma CRP,peripheral WBC and neutrophll are important to assess the serious degree of ACS. Elevated WBC count is a risk factor for developing CHF.