急性ST段抬高型心肌梗死患者入院白细胞计数与梗死面积的相关研究

The relationship between admission leukocyte count and the infarction area in ST-segment elevation acute myocardial infarction

目的研究急性ST段抬高型心肌梗死(STEMI)患者入院白细胞(WBC)计数与梗死面积的相关性及其对预后的影响。方法分析1078例急性STEMI患者,于胸痛发作<12h采血并采集心血管危险因素,分析患者入院WBC计数与临床指标的相关性。结果肌酸激酶(CK)峰值和肌酸激酶同工酶(CK-MB)峰值均与WBC计数呈显著正相关(r=0.321,P<0.01;r=0.276,P<0.01);CK和CK-MB的入院基础值也与WBC计数呈正相关性(r=0.132,P<0.01;r=0.077,P<0.05)。另外,入院WBC计数与患者的年龄呈显著负相关(r=-0.178,P<0.01)。结论急性STEMI患者入院WBC计数升高可能主要与梗死面积有关;未来应用WBC计数作为危险分层时,需考虑年龄因素的影响。

Objective To investigate the correlation between admission white blood cell （WBC） count and the infarction area in patients with ST-segment elevation acute myocardial infarction（ STEMI）, and its effect on prognosis. Methods Totally 1 078 patients presented with acute STEMI were enrolled within the first 12 hours from the onset symptom of continued chest pain. The total WBC count was obtained in the emergency department allocated to each patient. Baseline characteristics of the study population （age, risk factors and laboratory indices） were recorded and analyzed. Results The reactive elevation of WBC count is positively and significantly related to peak value of creatine kinase（CK） and creatine kinase MB isoenzyme（CK-MB） （ r = 0. 321, P 〈 0.01 ; r = 0. 276, P 〈 0.01 ）. The same positively correlation was observed between baseline value of CK and CK-MB and WBC account （ r =0. 132, P 〈 0.01 ; r = 0. 077, P 〈 0.05）. In addition, an negatively correlation was observed between WBC count and the age of patients （ r = - 0.178, P 〈 0.01 ）. Conclusion The infarction area of STEMI maybe the main reason that resulted in increasing WBC count. The age should be an risk factor for prognosis estimation in the future study.