急性心肌梗死患者血液生化指标与猝死的关系

Relationship between blood biochemical parameters and sudden death of the acute myocardial infarction

目的:探讨预测心肌梗死患者发生猝死的理化因素。方法:将我院冠心病监护室近一年来收治的急性心肌梗死发生猝死64例患者列为猝死组,同时收集2011年6-12月急性心肌梗死后病情稳定出院者69例归入对照组,收集临床资料并整理,包括年龄、性别、心肌酶谱及血液生化指标,并进行分析。结果:猝死组患者年龄高于对照组[(68.6±10.1)岁vs(61.7±14.0)岁,P<0.01];两组中男性年龄相比较差异有显著性[(67.7±10.7)岁vs(60.0±14.0)岁,P<0.05],而两组中女性之间差异无显著性[(70.8±8.5)岁vs(68.5±12.0)岁,P>0.05]。两组生化指标在白细胞总数、超敏C-反应蛋白、肌酸激酶同工酶(CK-MB)、肌红蛋白、丙氨酸氨基转氨酶(ALT)、门冬氨酸氨基转氨酶(AST)、血肌酐(CRE)差异有显著性(P<0.05),两组在脑尿钠肽(BNP)、尿素氮(BUN)、血糖(GLU)之间差异有非常显著性(P<0.01);而其他指标在两组之间差异无显著性。结论:年龄增加是影响心肌梗死预后的一个预测因子;血液指标的变化也可为患者预后提供预测依据。

Objective To explore the predictive biochemical factors of sadden death in acute myocardial infaretion（AMI）patients. Methods 64 AMI patients with sudden death in our coronary care unit over the past year were entered into sudden death group. 69 AMI patients withottt sudden death in our department from June, 2011 to December, 2011 were entered into the control group. The clinical data of these patients including the age, sex, myocardial enzyme, and blood biochemical parameters were analyzed. Results The male age was significant difference between the sudden death group and the control group （67.7± 10.7 vs. 60.0 ± 14.0, P 〈 0.05）, while there was no significant difference of the female age between the two groups （70.8 ±8.5 vs 68.5± 12.0, P 〉 0.05）. The values of WBC, hs-CRP, CK-MB, MYO, ALT, AST, and CRE in the sudden death group were higher than those in the control group （P 〈 0.05）. The values of BNP, BUN and GLU were significantly higher than those in the control group （P 〈 0.01 ）. No difference of other factors was found between the two groups. Conclusion Aging is a predictive factor affecting the prognosis of myocardial infarction. Changes in blood indicators can predict the prognosis of the AMI patients.