中性粒细胞升高对急性心肌梗死发生严重心律失常的预测意义  

The prognostic significance of neutrophils on serious arrhythmia in acute myocardial infarction

作　　者：常海霞[1] 巩晓宏[1] 尚磊[2] 辛渭川[1] 马锋[1] 丁辉[1] 龚敏[1] 张环[1] 雷靖祎[1] 秦建宁 王磊[1] 马前锋[1] 白引珠[1] 马东侠[1] 何琳[1] 张军科[4] 

机构地区：[1]西安市中心医院心内科,陕西省710003 [2]第四军医大学统计学教研室 [3]不详 [4]西安市中心医院心内科 陕西省蓝田县医院内一科,陕西省710003

出　　处：《中国心血管病研究》2012年第9期661-664,719,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的 了解中性粒细胞升高对急性心肌梗死（AMI）并发严重心律失常的临床意义.方法 对432例AMI患者进行前瞻性观察,收集患者发病情况及入院时血常规、心肌酶、心电图等检查结果,采用单因素和多因素统计分析方法分析各参数与严重心律失常间的关系.结果 AMI合并严重心律失常的患者白细胞（P＜0.01）和中性粒细胞（P＜0.01）水平较高,且短期死亡的风险也增加（P＜0.01）.严重心律失常多出现于发病早期（P＜0.01）.Logistic回归分析显示,AMI发生严重心律失常,与发病时间≤12 h（OR＝0.50,95%CI：0.10～1.45,P＝0.04）、短期死亡（OR＝6.45,95%CI：3.21～13.73,P＜0.01）及入院时中性粒细胞阳性（OR＝2.65,95%CI：0.84～4.56,P＝0.02）密切相关.结论 中性粒细胞计数＞7×109/L时AMI发生严重心律失常的风险明显增加.Objective To evaluate the clinical significance of elevated neutrophil in acute myocardial in- farction （AMI） occurring severe arrhythmia. Methods 432 cases of AMI were observed prospectively. The blood routine test, cardiac enzymes, electrocardiogram and other examination results were collected, and the relationship of various parameters and serious arrhythmia was analyzed using univariate and multivariate statistical analysis method in SPSS 16.0 software. Results Patients with serious arrhythmias had a higher baseline WBC count （P〈 0.01 ） and neutrophil （P〈0.01）. Serious arrhythmias were occurred in earlier onset of AMI （P=0.01）, and these patients were easy to merge the short-term death （P〈0.01）. In multiple regression analysis, serious arrhythmias in AMI related with onset time less than 12 hours（P=0.04, OR=0.50, 95%CI：0.10-1.45）, short-term mortality （P〈0.01, 0R=6.45, 95%CI：3.21-13.73）and elevated neutrophil （P=0.02, 0R=2.65, 95%C1：0.84-4.56）. Conclusion The neutrophils count〉7×10^9/L is the prognostic factor for serious arrhythmia in AMI.

关 键 词：中性粒细胞 心肌梗塞 严重心律失常 

分 类 号：R542.22[医药卫生—心血管疾病]