白细胞计数在非ST段抬高型急性冠脉综合征患者入院早期危险分层中的作用

White cell count in Non-ST segment elevation of patients with acute coronary syndrome

目的评价白细胞计数在非ST段抬高型急性冠脉综合征（NSTE—ACS）患者入院早期危险分层中的作用。方法407例NSTE-ACS患者，入院早期（〈48h）行冠脉造影检查并采集症状发作至入院36h内白细胞计数和心肌钙蛋白Ⅰ（cTnI）检测结果，以白细胞计数〉11×10^9／L作为阳性结果，以≤11×10^9／L作为阴性结果，据此把所有患者分为白细胞阳性组和白细胞阴性组。收集一般临床资料，评价两组间基本资料及早期侵入性检查（〈48h）应用情况，统计院内主要不良心脏事件（MACE）。结果407例NSTE—ACS患者中，白细胞阳性77例，白细胞阴性330例，白细胞阳性组与白细胞阴性组在（cTnI）阳性比例（41．6％vs22．1％，P〈0．05）、冠脉病变SCAI分型Ⅰ型病变（9．1％VS21．5％，P〈0．05）、冠脉病变SCAI分型Ⅳ型病变（29．9％vs12．4％，P〈0．01）、心衰（55．4％vs38．2％，P〈0．01）、院内发生主要心脏事件（7．5％vs3．8％，P〈0．05）组间比较差异有统计学意义。结论白细胞计数对NSTE—ACS患者危险分层具有一定临床参考价值。

Objective To study the association of WBC count with early risk stratification in acute coronary syndrome patients with non - ST segment elevation. Methods 407 ACS patients with NSTE were admitted and their WBC were counted and cardiac troponin （ cTnⅠ ） measured within the first 36 hours from symptom onset after admission. All patients received coronary angiography within 48 h. Positive results were recorded if WBC count 〉 11 × 10^9/L, and negative results were recorded if WBC count ≤ 11 ×10^9/L. We examined the relationships between results of two sets and incidences of in -hospital major adverse cardiac event （MACE）and early eatheter- based interventions. Results Among 407 ACS patients with NSTE, 77 had WBC ＋, and 330 WBC -. Results of cTnI level （41.6% vs 22.1% ,P 〈 0.05 ）, types of damaged coronary artery （ type Ⅰ ：9.1%0 vs 21.5% ,P 〈 0.05 ;type Ⅳ ：29.9% v s 12.4% ,P 〈 0.01 ）, heart failure（55.4% vs 38.2% ,P 〈 0.01 ）, and the incidence of MACE had statistically significant difference between positive WBC and negative WBC groups. Conclusions WBC count has clinical prognostic value in risk stratification of ACS patients with NSTE.