摘要
目的评价急性ST段抬高心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)后中性粒细胞水平与ST段下降幅度(STR)及血浆N末端利钠肽原(NT-proBNP)相关性。方法入选发病12小时内成功接受PCI的STEMI患者195例。PCI术前、术后2小时分别记录18导联心电图,PCI术后12小时进行中性粒细胞计数和NT—proBNP水平检测,随访6个月。记录主要心脏不良事件(MACE)。根据其中性粒细胞水平分为3组:A组(中性粒细胞〈4.78×10^9/L)32例;B组[中性粒细胞(4.78~8.79)×10^9/L]118例;C组(中性粒细胞〉8.79×10^9/L)45例。结果C组PCI术后2小时STR〉70%所占比率较A组明显减少(17.8%VS43.8%,P<0.05);STR〈30少6组高中性粒细胞(〉8.79×10^9/L)血症、高血浆NTproBNP(〉600pmo/L)比率均明显高于STR〉70%组(33.3%vs13.8%、34.9%vs12.3%,P〈0.05或〈0.01);直线相关分析显示,C组中性粒细胞与NT—proBNP水平呈正相关(r=0.401,P〈0.01);随访6个月,3组MACE发生率差异无统计学意义(P〉0.05)。结论PCI后中性粒细胞水平与STR和NT—proBNP水平密切相关,PCI后中性粒细胞数早期监测有利于急性心肌梗死患者PCI后心肌组织灌注水平和临床预后的评价。
Objective To explore the correlation of postprocedural neutrophil count, ST-segment resolution (STR) and NT proBNP in ST elevation myocardial infarction patients (STEMI) after percutaneous coronary intervention( PCI ). Methods A total of 195 STEMI patients who underwent successful PCI were enrolled. Electrocardiograms were recorded before PCI and two hours after PCI. Neutrophii counts and NT-proBNP were measured within 12 hours after PCh Cardiac main adverse cardiac events(MACE) were also recorded during the followup survey after six months( P 〈0.05). According to the level of neutrophil after PCI,the patients were divided into three groups:group A(neutrophil〈4.78 × 10^9/L),group B(neutrophil 4.28-8.79) × 10^9/L,group C(neutrophil〉 8.79 ×10^9/L). Results Compared with group A, patients in group C less frequently had complete STR (17.8% vs 43.8%, P〈0.05). The percentages of high neutrophil and plasma NT proBNP were significantly higher in patients with STR〈30% ,compared those in patients with STR〉70%(33.3% vs 13.8%,34.9% vs 12.3%, P 〈0.05 or 0.01). Linear relativity analysis showed that postprocedural neutrophil count was positively correlated with the level of NT-proBNP in group C. No statistical differences were found between the groups at incidence of six months MACE( P 〉 0.05). Conclusion There is a strong association between postprocedural neutrophil count, STR and NT-proBNP, suggesting the early measurement of postprocedural neutrophil count is helpful in evaluating the reperfusion of myocardium and the prognosis of patients with acute myocardial infarction.
出处
《临床荟萃》
CAS
2010年第4期305-308,共4页
Clinical Focus
关键词
心肌梗死
血管成形术
支架
中性粒细胞
利钠肽
脑
myocardial infarction
angioplasty
stents
neutrophil
natriuretic peptide, brain