白细胞计数、空腹血糖、血脂及其他实验室指标在不同范围急性心肌梗死中的差异及临床意义

White Blood Cell Count,Fasting Plasma Glucose,Plasma Lipids and Other Laboratory Tests During the Course of Acute Myocardial Infarction:an association with infarct size.

目的比较不同面积急性心肌梗死(AMI)时血液常规、生化指标及住院病死率的差异,探讨影响梗死面积的因素。方法大面积心肌梗死组87例,小范围心肌梗死组114例,比较两组基本临床特征、ST抬高导联数、白细胞(WBC)计数、血红蛋白(Hb)、空腹血糖(FBG)、血脂、血尿酸(UA)等指标及住院病死率的差别,分析各变量之间的相关关系。结果两组基本临床特征具有可比性(P>0.05);ST抬高导联数、WBC计数、FBG、总胆固醇(Tch)、低密度脂蛋白(LDL)存在显著性差异,P<0.05;两组住院死亡率4.39%vs19.45%(P=0.001)。ST抬高导联数与WBS、FBG正相关(r=0.267,P=0.049*;r=0.273,P=0.003**;FBG与LDL、ApoB正相关(r=0.199,P=0.006**;r=0.277,P=0.000**);WBC与UA、FBG正相关(r=0.227,P=0.003**;r=0.175,P=0.017*)。结论急性心肌梗死范围越大,白细胞计数越高,血糖、血脂异常越明显,住院病死率越高。应积极干预炎症反应及糖、脂代谢异常以利缩小梗死范围、降低住院病死率。

Objective To compare laboratory tests and in -hospital mortality in acute myocardial infarction （AMI） with different infarction size and to seek factors correlate with infarction size. Methods Totally 201 AMI patients were enrolled , 87 patients had large size infarction , 114 patients had small size infarction . Basic characteristics , the number of ST - segment elevation leads , in - hospital mortality , white blood cell （WBC） count , fasting plasma glucose （FBG） , plasma lipids and other laboratory tests in the two groups were compared . All variables were compared their correlations. Results There were statistical differences between the two groups at number of ST -segment elevation leads, in -hospital mortality,WBC count,FBG,total cholesterol （Tch） and low -density lipoproteincholesterol （LDL） ,P 〈 0.05. Correlation analysis： WBC count vs number of ST- segment elevation leads （r = 0. 267, P = 0. 049 ^＊ ）, FBG vs number of ST - segment elevation leads （ r = 0. 273,P = 0. 003 ^＊＊ ） . Conclusions The larger size of acute myocardial infarction , the bigger amount in WBC count, FBG, Tch, LDL and in -hospital mortality. The WBC count and FBG were correlate with infarction size. To treat with inflammation action and abnormal glucose / fat metabolism should be useful to reduce infarction size and in - hospital mortality.