白细胞计数与急性冠状动脉综合征的相关性

Relationship between white blood cell count and acute coronary syndrome

目的探讨外周血白细胞(WBC)计数和血脂水平变化与急性冠状动脉综合征(ACS)发生发展及冠状动脉病变程度和范围的关系。方法对ACS患者、稳定性心绞痛(SAP)患者和健康对照者WBC计数和血脂水平进行分析比较。其中67例冠心病(CAHD)患者行冠状动脉造影,按照造影结果分为单支和多支病变组,比较其WBC数和血脂水平。结果ACS组WBC计数与血清TC(总胆固醇)、TG(甘油三脂)、LDL-C(低密度脂蛋白胆固醇)水平均显著高于SAP组和对照组(均P<0.05),而HDL-C水平则显著低于后两组(P<0.05)。CAHD患者WBC计数与血清TC、TG、LDL-C水平呈正相关,而与血清HDL-C水平呈负相关。多支病变组WBC计数显著高于单支病变组和对照组(P<0.05)。结论外周血WBC参与了ACS的发生与发展,并且WBC数升高与冠脉病变的程度和范围密切相关,为临床评价动脉粥样斑块的不稳定性提供了一个简单、方便、价廉的良好指标。

Objective To explore the correlation between levels of serum lipid, white blood cell （WBC） count and occurrence, development of acute coronary syndrome. Methods WBC count and levels of serum lipid were measured and compared in patients with acute coronary syndrome （ACS） , patients with stable angina pectofis （SAP） and controls. 67 patients with coronary atherosclerotic heart disease （CAHD） underwent quantitative angiographic assessment. The difference of WBC count and levels of serum lipid in patients with single coronary artery pathological changes were compared with those in patients with multiple coronary artery pathological changes. Results WBC count and serum concentrations of TC, TG, LDL-C in the ACS group were significantly higher than those in the SAP and control groups, respectively （P〈0.05）, but HDL-C was significantly lower than that in the SAP and control groups （P〈0.05）. Linear correlation analysis revealed that WBC count were positively associated with serum concentrations of TC, TG, LDL-C, but it was negative associated with serum HDL-C. WBC count in the multiple coronary artery pathological changes group was significantly higher than that in other groups （P〈 0.05）. Conclusion WBC count not only plays an important role in the occurrence and development of ACS, but also is associated with extent and severity of coronary artery disease. It can be used as a simple, inexpensive and readily available marker for evaluating atherosclerotic plaque destabilization.