急性心肌梗死患者入院时血白细胞计数 中性粒细胞比率与住院期间不良结局的关系

Association Between Admission White Blood Cell Count,Percentage of Neutrophilic and In-hospital Bad Outcomes in Patients with Acute Myocardial Infarction

目的分析急性心肌梗死（AMI）患者入院血白细胞（WBC）计数、中性粒细胞（NG）比率与住院期间不良结局的关系。方法将849例初发AMI患者按不同临床特征（性别、年龄、住院期间并发症及并发症数量、出院时心功能）分组，分析各组入院时血WBC计数、NG比率的特点，采用多因素Logistic~归方法分析入院时血wBc计数、NG比率与住院期间不良结局的关系，并进一步分析人院时不同水平WBC计数、NG比率与住院期间不良结局的关联性。结果人院时血WBC计数、NG比率升高使AMI患者住院期间发生死亡、心功能33级和复合结局的危险性显著增加，P〈0．01；经多因素调整后，以入院时WBC计数〈8．0×109／L作为参比，WBC计数≥10．0×109／L与死亡、心功能≥3级和复合结局关联性C暖分别是2．343（1．280-4．285），2．116（1．162-3．852），2．502（1．389-4．507）。结论入院时血WBC水平升高显著增加AMI患者住院期间发生死亡、心功能≥3级和复合结局的危险性，人院时WBC≥10．0×109／1．是AMI患者住院期间发生死亡、心功能≥3级和复合结局的独立危险因素。

Objective To study the association between admission WBC count,percentage of NG and in-hospital bad outcomes in patients with AMI.Methods 849 patients with beginning AMI were grouped according to different clinical characteristics（gender, age,different heart function on discharge,with or without complication,amount of complications,etc）.With features of admission WBC count and percentage of NG in different groups analyzed and multivariate logistic regression method applied,the relationship between WBC count,percentage of NG and in-hospital bad outcomes was analyzed.The relevance between in-hospital bad outcomes and different levels of WBC count and percentage of NG was further analyzed.Results With the rise of admission WBC count and percentage of NG,the risk of in-hospital death,heart function ≥ 3 degree and combined outcome increases significantly,P 〈 0.0 I.OR of above mentioned bad outcomes were 2.343,2.116,2.502 respectively for patients with admission WBC count≥ 10.0 x 109/L compared to WBC count 〈 8.0 × 10^9/L after multivariate adjustment.Conclusion Elevated admission WBC count level and percentage of NG significantly increase the risk of in-hospital bad outcomes ofAMI.Admission WBC count≥ 10.0 x 09/L is an independent risk factor for the in-hospital bad outcomes of AMI.