急性脑梗死早期血白细胞计数动态变化及其临床意义

Changes of the white blood cell(WBC)count and its clinical significance in early stage of acute cerebral infarction

目的 探讨脑梗死急性期外周血白细胞计数与脑梗死发生发展及预后的相关性。方法 对 2 812例脑梗死患者进行回顾性统计 ,以白细胞计数 10× 10 9 L分组 ,大于此数患者归入异常组 ,小于则属于正常组 ,分别就两组在1～ 3d、4～ 6d、7～ 10d分三个阶段进行白细胞计数 ,并与死亡率 ,意识同时统计 ,并作死亡与生存患者的白细胞分析。结果 白细胞升高组的病死率明显高于正常组 ,白细胞计数逐步升高时病死率也随着递增 ,死亡组患者的白细胞计数显著高于生存组患者 ,白细胞计数递增与意识状态的障碍变化严重程度存在着相关性 ,同级意识状态在不同时段的白细胞变化无差异显著性。结论 脑梗死早期出现的白细胞计数升高的机制是脑损伤达到一定的严重程度后产生的应激反应 ,是脑梗死患者病情严重与预后差的一个重要原因 ,白细胞计数与后果存在明显的相关性 。

Objective To explore the correlation between peripheral WBC count in acute cerebral infarction and the development and prognosis of the disease.Methods Retrospective statistics of 2?812 severe cerebral infarction patients were carried out.The patients were divided into two groups according to WBC count:those with WBC count higher than 10×10 9/L were assigned to abnormal group and those with WBC count lower than 10×10 9/L were assigned to normal group.WBC count at three stages (1～3,4～6,7～10 d) was calculated at the same time with death rate and consciousness.An analysis of the WBC count of the dead and the survivors was made.Results The fatality rate of the abnormal group was obviously higher than that of the normal group.The fatality rate increased with the rise of WBC count,which was obviously higher in the dead than in the survivors.There was correlation between the inrease in WBC count and the severity of disorder of consciousness state.Conclusions It is the stress after brain injury to a certain severity that leads to the increase in WBC count,which is the important reason for the serious condition and poor diagnosis of the patient. As an obvious correlation is established between WBC count and the outcome,WBC count can be a simple and easy predictor of the prognosis of cerebrovascular diseases.