心肌梗死前心绞痛和白细胞计数对急性心肌梗死患者左室射血功能的影响

Effects of prodromal angina pectoris and white blood cell count on left ventricular ejection of patients with acute myocardial infarction

目的探讨心肌梗死前心绞痛和白细胞计数与急性心肌梗死(AMI)后左室射血分数(LVEF)的关系。方法选择48例初发的前壁ST段抬高AMI患者,均在入院时检测白细胞计数,入院后30 min内溶栓治疗,记录AMI发生前24 h内出现的心绞痛,在入院时和出院前测LVEF。结果白细胞计数升高与出院前低LVEF有关;心肌梗死前心绞痛与出院前LVEF的增加有关,有心肌梗死前心绞痛患者白细胞计数更低。Logistic回归分析显示白细胞计数、心肌梗死前心绞痛均与LVEF密切相关。结论白细胞计数升高和心肌梗死前心绞痛的缺乏与再灌注治疗后LVEF受损有关,心肌梗死前心绞痛可能通过抗炎作用使LVEF改善。

Objective It is to study the relationship of prodromal angina pectoris and white blood cells （WBC） count with left ventricular ejection（LVEF） in the patients with acute myocardial infarction （AMI）. Methods 48 patients with first anteri- or wall ST - segment elevation AMI were chosen and given thrombolytic therapy in 30 min after admission, before that their WBC count was measured at the time of hospital admission. Prodromal angina pectoris was recorded within 24 h before the on- set of AMI. LVEF was measured before thrombolytic therapy and prior to discharge. Results High WBC count was associated with lower LVEF. Prodromal angina pectoris was associated with increased LVEF before leaving hospital.. The patients with prodromal angina peetoris had lower WBC count. WBC count and prodromal angina had close relationship with LVEF by Logis- tic regression analysis. Conclusion Increasing of WBC eount and lack prodromal angina peetoris was associated with impaired left veutricular function. Prodromal angina might have improved LVEF through its anti-inflammatory effect.