白细胞计数与急性非ST段抬高型心肌梗死患者预后相关关系的研究  

Correlation of white blood cell count and prognosis in patients with acute non-STsegment elevation myocardial infarction

作　　者：李群[1] 王德昭[1] 王军[2] 胡宏宇[1] 付强[1] 陈威[1] 郭彩霞[1] 陈步星[1] 

机构地区：[1]首都医科大学附属北京天坛医院心内科,北京100050 [2]北京市门头沟区医院心内科,北京102300

出　　处：《首都医科大学学报》2016年第4期550-554,共5页Journal of Capital Medical University

摘　　要：目的探索白细胞计数对急性非ST段抬高型心肌梗死（non-ST-segment elevation myocardial infarction,NSTEMI）患者预后的预测价值。方法回顾分析了198例急性NSTEMI患者的随访资料。入院时即刻检测血白细胞计数。研究的主要终点是死亡、再发心肌梗死、再次血运重建和脑卒中。使用多因素回归分析影响预后的因素。结果 2组患者基线资料除入院时心率和肌酸激酶同工酶外差异均无统计学意义,白细胞计数〉11.0×10^9/L组住院期间和出院后6个月主要不良心脑血管事件发生率明显高于白细胞计数≤11.0×10^9/L组（25.5%vs 10.4%,P=0.006;18.4%vs 5.2%,P=0.004）,Logistics多因素回归分析显示白细胞计数〉11.0×10~9/L是住院期间主要不良心脑血管事件的独立危险因素（OR=2.942,95%CI：1.333~6.495,P=0.008）,Cox多因素回归分析显示白细胞计数〉11.0×10~9/L是出院后6个月主要不良心脑血管事件的独立危险因素（RR=3.767,95%CI：1.406~10.089,P=0.008）。结论白细胞计数升高是急性NSTEMI患者心脑血管事件发生的独立危险因素。Objective We aimed to evaluate the relationship between white blood cell count（ WBC） and prognosis in patients with non-STsegment elevation myocardial infarction（ NSTEMI）. Methods We retrospectively enrolled 198 patients with NSTEMI and analyzed follow-up data. All patients were admitted to hospital after immediate detection of WBC. Mortality,re-infarction,revascularization,and stroke were the primary end point. Multivariate regression revealed prognostic factors. Results There was no significant difference of the baseline data except of heart rate and creatine kinase isozyme between two groups. We found that patients of WBC 〉11. 0 × 10^9/ L group had more main adverse cardiovascular and cerebrovascular events（ MACCE） at the time in hospital and in the six months after discharge than those of WBC≤〉11. 0×10^9/L group. In multivariate logistic regression analysis,WBC 〉11. 0 ×10^9/ L（ OR = 2. 942,95% CI： 1. 333-6. 495,P = 0. 008） was independent predictors for MACCE at the time in hospital. In multivariate cox regression analysis,WBC〉11. 0×10^9/ L（ RR = 3. 767,95% CI： 1. 406-10. 089,P = 0. 008） was independent predictors for MACCE in the six months after discharge. There was no significant differences of the baseline data except of heart rate and creatine kinase isozyme between two groups. We found that patients of WBC〉11. 0×10^9/ L group had more main adverse cardiovascular and cerebrovascular events（ MACCE） at the time in hospital and in the six months after discharge than those of WBC≤〉11. 0×10^9/L group. In multivariate Logistic regression analysis,WBC 〉11. 0 ×10^9/ L（ OR： 2. 942,95% CI： 1. 333-6. 495,P = 0. 008） was independent predictors for MACCE at the time in hospital. In multivariate cox regression analysis,WBC〉11. 0×10^9/ L（ RR： 3. 767,95% CI： 1. 406-10. 089,P= 0. 008） was independent predictors for MACCE in the six months after discharge. Conclusion The high WBC is an independent predictor of MACCE in patients with NSTEMI.

关 键 词：白细胞计数 非ST段抬高型心肌梗死 预后 

分 类 号：R54[医药卫生—心血管疾病]