白细胞计数联合D-二聚体在冠心病急性期死亡预测的意义初探

Preliminary study of prediction death for white blood cell count combined with D-dimer in acute stage of coronary heart disease

目的探讨血液中白细胞计数（WBC）联合D-二聚体（D-D）的检测与冠心病患者急性期死亡预测的意义。方法选择经冠状动脉造影确诊的103例冠心病患者,其中男性55例,女性48例;年龄49~76岁,平均年龄59.06岁。将其设为冠心病组,其中不稳定心绞痛（UA）组40例,急性心肌梗死（AMI）组38例,死亡组25例。健康体检人群45例设为对照组,其中男性24例,女性21例;年龄40~72岁,平均年龄58.38岁。测定各组WBC及D-D含量,并运用SPSS 17.0统计学软件对各组检测值进行统计学分析和处理。结果 WBC水平及D-D含量冠心病组与对照组相比明显升高,差异有统计学意义（P〈0.05）;而在冠心病各组中进行比较,死亡组WBC及D-D含量增高更加明显,差异有统计学意义（P〈0.05）。WBC≥10×109/L的冠心病组死亡率明显高于WBC〈10×109/L的冠心病组;同样,D-D≥0.5μg/m L的冠心病组死亡率也明显超过D-D〈0.5μg/m L的冠心病组。WBC与D-D含量有一定的正相关性（r=0.454,P〈0.05）。结论联合检测冠心病急性期患者的WBC及D-D水平,可能对判断冠心病的病情尤其是急性期危险性及预后的评价有重要价值。

Objective To examine the serum levels of white blood cell count（WBC） combined with D-dimer（D-D） in acute stage of patients coronary heart disease（CHD）, and study the significance of death prediction. Methods A total of 103 CHD patients were enrolled, which were 55 males and 48 females, aged 49- 76 years old with mean age of 59.06 years old. The 103 patients were set as case group（CHD group）, which included unstable angina（n = 40, UA group）, acute myocardial infarction（n = 38, AMI group）and death（n = 25, death group）. Forty-five healthy were set as control group, which were 24 males and 21 females, aged 40- 72 years old with mean age of 58.38 years old. The serum levels of WBC and D-D were measured, and the detection values of each group were analyzed and processed by statistical software SPSS 17.0. Results The level of WBC and D-D in CHD group were significantly higher than those in control group（P 〈 0.05）; The WBC and D-D in death group were significantly increased in CHD groups（P 〈 0.05）. The death rate of WBC ≥ 10 × 109/L in CHD group was significantly higher than that of WBC 〈 10 × 109/L in CHD group. The death rate of D-D ≥ 0.5 μg/m L in CHD group was significantly higher than that of D-D 〈 0.5 μg/m L in CHD group, the positive correlation existed between serum WBC and D-D（r = 0.454, P 〈 0.05）. Conclusion It is demonstrated that combined detection of serum levels of WBC and D-D in CHD patients could show the severity of CHD, especially in acute stage of risk and prognostic value.