中性粒细胞与钾离子浓度联合诊断急性ST段抬高型心肌梗死的应用价值

The Applicative Value of Neutrophils and Potassium Ion Concentration as Joint Diagnosis of Acut Myocardial Infarction with ST segment Elevation

目的评价中性粒细胞与血钾水平联合检测诊断早期ST段抬高型心肌梗死的应用价值。方法将河北省沧州市人民医院自2012年8月至2013年12月收治的急性心肌梗死(AMI)患者93例按心电图特征分成ST段抬高型心肌梗死组(抬高组)49例与非ST段抬高型心肌梗死组(非抬高组)44例,将同期健康体检者45例作为对照组,进行中性粒细胞检测及血钾水平测定。结果抬高组血钾水平显著低于对照组及非抬高组[(3.4±1.0)nmol/L比(4.2±1.2)nmol/L,(4.2±1.1)nmol/L,P<0.05];抬高组中性粒细胞计数显著高于对照组及非抬高组[(10.6±2.2)×109/L比(4.8±3.1)×109/L和(8.7±1.5)×109/L,P<0.05];高血钾组中性粒细胞计数低于低血钾组[(8.6±1.3)×109/L比(10.9±1.2)×109/L,P<0.01],高血钾组发病至入院时间长于低血钾组[(13.6±5.1)h比(6.3±2.2)h,P<0.01];抬高组患者血钾水平与发病时间呈正相关(r=0.415,P<0.05),而与中性粒细胞计数呈负相关(r=-0.378,P<0.05)。结论早期ST段抬高型心肌梗死患者易出现低血钾症,监测患者中性粒细胞计数及血钾水平有利于早期诊断。

Objective To analyze the application value of neutrophils and blood potassium ion concentration as joint diagnosis for early myocardial infarction with ST segment elevation. Methods A total of 93 patients with acute myocardial infarction（ AMI） admitted to Cangzhou People＇ s Hospital of Hebei Province from Aug. 2012 to Dec. 2013 were included in the study,and were divided into ST segment-elevated myocardial infarction group（ elevation group,49 cases） and non-ST segment-elevated myocardial infarction group（ non-elevation group,44 cases） according to the characteristic of ECG,and another 45 healthy subjects during the same period were included as control group. The neutrophils and serum potassium content of the three groups were tested. Results The serum potassium level of the elevation group was significantly lower than that of the control group and non-elevation group [（ 3. 4 ± 1. 0） nmol / L vs（ 4. 2 ± 1. 2） nmol / L,（ 4. 2 ± 1. 1） nmol/L,P 0. 05]; the neutrophil count of the elevation group was significantly higher than that of the control group and non-elevation group [（ 10. 6 ± 2. 2） × 109/ L vs（ 4. 8 ± 3. 1） × 109/ L,（ 8. 7 ±1. 5） × 109/ L,P 0. 05 ]; the neutrophil count of the hyperkalemia group was lower than the hypokalemia group[（ 8. 6 ± 1. 3） × 109/ L vs（ 10. 9 ± 1. 2） × 109/ L,P 0. 01 ],onset to admission time of the hyperkalemia group was longer than the hypokalemia group [（ 13. 6 ± 5. 1） h vs（ 6. 3 ± 2. 2） h,P 0. 01];the serum potassium concentration elevation had a positive correlation with time of onset（ r = 0. 415,P 0. 05）,but a negative correlation with neutrophil count（ r =- 0. 378,P 0. 05）. Conclusion Patients with ST segment-elevated myocardial infarction in early stage are prone to disease of hypokalemia,and monitoring of neutrophils count and serum potassium level is helpful to the early diagnosis.