入院时白细胞计数对急性ST段抬高型心肌梗死患者长期预后的影响  

Effect of white blood cell count on admission on long-term prognosis of patients with acute ST-segment elevation myocardial infarction

作　　者：王丽[1] 刘昶[1] 韩桢[1] 郭杰 刘严[2] Wang Li;Liu Chang;Han Zhen;Guo Jie;Liu Yan(Department of Emergency Medicine,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;不详)

机构地区：[1]首都医科大学附属北京友谊医院急诊科,北京100050 [2]清华大学玉泉医院急诊科

出　　处：《中国临床保健杂志》2022年第1期123-127,共5页Chinese Journal of Clinical Healthcare

摘　　要：目的探讨入院时外周血白细胞计数对急性ST段抬高型心肌梗死(STEMI)患者长期预后的影响。方法回顾性分析2015年1月至2020年1月于首都医科大学附属北京友谊医院和清华大学玉泉医院心脏重症监护病房确诊急性STEMI且接受急诊经皮冠状动脉介入治疗(PCI)的274例患者的临床资料。到院时采集静脉血,测定白细胞计数(WBC),按照WBC水平不同分为两组,≤9.5×10^(9)/L为A组,>9.5×10^(9)/L为B组,对两组患者的临床资料、心血管事件以及长期预后进行比较。出院后对患者进行随访,评价长期预后。患者出院后随访36个月的主要心脏不良事件(MACE),MACE发生率的比较使用生存分析Kaplan-Meier法;采用Cox回归分析多个变量与临床长期预后的关系。结果随访36个月,两组患者的累积MACE发生率A组(4.8%)明显低于B组(10.3%),差异有统计学意义(P=0.012)。Cox回归分析显示年龄(HR:1.135,95%CI:1.011~1.275,P=0.033)、吸烟史(HR:0.689,95%CI:0.519~0.915,P=0.010)、WBC(HR:1.356,95%CI:1.005~1.831,P=0.046)是MACE的危险因素。结论入院时外周血WBC计数可能是影响急性STEMI且接受PCI患者的长期预后的危险因素。Objective To explore the effect of peripheral blood white blood cell count on admission on the long-term prognosis of patients with acute ST-segment elevation myocardial infarction(STEMI).Methods The clinical data of 274 patients with acute STEMI and treated with emergency PCI in the cardiac intensive care unit of Beijing Friendship Hospital and Yuquan Hospital of Tsinghua University from January 2015 to January 2020 were retrospectively analyzed.WBC count was measured at the hospital.According to the WBC count level,the patients were divided into two groups:group A:(WBC≤9.5×10^(9)/L,n=132),group B:(WBC>9.5×10^(9)/L,n=142).The clinical data,cardiovascular events and long-term prognosis of the two groups were compared.Patients were followed up after discharge to evaluate long-term prognosis.Patients were followed up 36 months after discharge for major adverse cardiac events(MACE),and the incidence of MACE was compared using Kaplan-Meier survival analysis.Cox regression was used to analyze the relationship between multiple variables and long-term clinical outcomes.Results After 36 months of follow-up,the cumulative incidence of MACE in group A(4.8%)was significantly lower than that in group B(10.3%),with statistical significance(P=0.012).Cox regression analysis showed age(HR:1.135,95%CI:1.011-1.275,P=0.033),smoking history(HR:0.689,95%CI:0.519-0.915,P=0.010),WBC count(HR:1.356,95%CI:1.005-1.831,P=0.046)were the risk factors for MACE.Conclusions Peripheral blood WBC count on admission may be a risk factor for long-term prognosis of patients with acute STEMI who underwent PCI.

关 键 词：ST段抬高型心肌梗死 白细胞计数 危险因素 预后 

分 类 号：R542.22[医药卫生—心血管疾病]