急性ST段抬高型心肌梗死患者外周血白细胞、血小板和血红蛋白含量与预后的关系

Relationship between content of white blood count,platelet and hemoglobin and prognosis in patients with acute ST-segment elevation myocardial infarction

目的探讨急性ST段抬高型心肌梗死(STEMI)患者行经皮冠状动脉介入治疗(PCI)术后主要不良心血管事件(MACE)与外周血白细胞、血小板和血红蛋白含量的关系。方法连续入组2014年1月至2014年12月于我院进行PCI的STEMI患者393例,平均随访30.4个月得到MACE的发生情况,依据是否发生MACE将患者分为MACE组和非MACE组,回顾分析2组患者的临床资料,比较两组患者的一般临床资料及血常规。采用多因素Logistic回归分析,以单因素分析P<0.05的变量进入多因素逐步回归模型,分析影响STEMI患者发生MACE的危险因素。结果与未发生MACE的STEMI患者相比,发生MACE的患者年龄更大,血清中总胆固醇水平更高(P<0.05);血常规中白细胞计数、血小板计数明显升高,血红蛋白明显降低(P<0.05)。多因素Logistic逐步回归分析显示,年龄、总胆固醇水平、白细胞和血小板计数是STEMI患者发生MACE的危险因素,而血红蛋白则是保护因素。结论血常规中白细胞升高、血小板升高及血红蛋白降低是STEMI患者发生MACE的独立危险因素,对STEMI患者发生MACE具有预测价值,为临床预测和防治MACE提供参考价值。

Objective To investigate the relationship between major adverse cardiovascular events(MACE)and content of white blood count(WBC),platelet and hemoglobin(Hb)in patients with acute ST-segment elevation myocardial infarction(STEMI)undergone percutaneous coronary intervention(PCI).Methods STEMI patients undergone PCI(n=393)were chosen from the First Affiliated Hospital of Xi’an Jiaotong University from Jan.2014 to Dec.2014,and the incidence status of MACE was observed after followed up for average 30.4 months.All patients were divided,according to MACE incidence,into MACE group and non-MACE group.The clinical materials were retrospectively analyzed in 2 groups,and general clinical data and blood routine examinations were compared between 2 groups.The risk factors of MACE were analyzed in STEMI patients by using multi-factor Logistic regression analysis after brought single-factor variables with P<0.05 into multi-factor stepwise regression model.Results The patients were older and their level of serum total cholesterol(TC)was higher in MACE group compared with non-MACE group(P<0.05).In blood routine examinations WBC and platelet count increased significantly,and Hb content decreased significantly in MACE group(P<0.05).The results of Logistic stepwise regression analysis showed that age,TC level,WBC and platelet count were risk factors of MACE,and Hb was a protective factor in STEMI patients.Conclusion The increases of WBC and platelet and decrease of Hb are independent risk factors of MACE,which have predictive,preventive and therapeutic value to incidence of MACE in STEMI patients.