白细胞计数与急性ST段抬高型心肌梗死病人直接经皮冠状动脉介入术中无复流的关系

doi:10.3969/j.issn.1006-7795.2017.03.009

首都医科大学学报 ›› 2017, Vol. 38 ›› Issue (3): 372-376.doi: 10.3969/j.issn.1006-7795.2017.03.009

• 心血管疾病的诊断与治疗 • 上一篇下一篇

白细胞计数与急性ST段抬高型心肌梗死病人直接经皮冠状动脉介入术中无复流的关系

吴晴晴¹, 华琦¹, 薛淞², 张迎花¹, 司瑾¹, 李静¹

1. 首都医科大学宣武医院心脏科, 北京 100053;
2. 首都医科大学康复医学院北京博爱医院心内科, 北京 100068

收稿日期:2017-01-14 出版日期:2017-05-21 发布日期:2017-06-14
通讯作者: 李静 E-mail:youyoubaby@yeah.net
基金资助:
国家自然科学基金（81470491）。

Relationship between white blood cell count and intra-operative no-reflow of acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Wu Qingqing¹, Hua Qi¹, Xue Song², Zhang Yinghua¹, Si Jin¹, Li Jing¹

1. Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
2. Department of Cardiology, Beijing Boai Hospital, Capital Medical University, Beijing 100068, China

Received:2017-01-14 Online:2017-05-21 Published:2017-06-14
Supported by:
This study was supported by National Natural Science Foundation of China(81470491).

摘要/Abstract

摘要： 目的探讨白细胞计数与急性ST段抬高型心肌梗死（ST-segment elevation myocardial infarction，STEMI）病人直接经皮冠状动脉介入术（percutaneous coronary intervention，PCI）中无复流的关系。方法选取2013年11月至2015年12月因急性STEMI住院并行直接PCI的病人266例，根据PCI术中无复流发生情况分为正常复流组（A组）242例和无复流组（B组）24例。比较两组病人临床资料特点及住院期间主要不良心血管事件（major adverse cardiovascular events，MACE）发生率，采用Logistic回归分析筛选急性STEMI病人PCI术中无复流的影响因素。结果无复流组白细胞计数、血肌酐明显高于正常复流组（P<0.05），Killip ≥ 3级比例显著升高（P=0.009）；两组病人住院期间MACE发生率分别为16.7%和2.9%（P=0.001）。多因素Logistic回归分析结果显示白细胞计数（OR=1.220，95%CI：1.064~1.399，P=0.004）、Killip分级（OR=4.617，95%CI：1.093~2.095，P=0.037）是急性STEMI病人PCI术中无复流的独立预测因素。结论入院时白细胞计数是急性STEMI病人PCI术中无复流的独立预测因素，早期检测白细胞计数可以初步评估PCI术中无复流的发生风险。

关键词: 心肌梗死, 白细胞, 无复流, 缺血再灌注损伤, 经皮冠状动脉介入

Abstract: Objective To investigate the relationship between leukocyte count and Intra-operative no-reflow of acute ST-segment elevation myocardial infarction (STEMI) patients with percutaneous coronary intervention (PCI). Methods Two hundred and sixty-six acute STEMI patients were categorized into group A (without intra-operative no-reflow, n=242) and group B (with intra-operative no-reflow, n=24) according to the intra-operative no-reflow.Clinical data were compared between the two groups, including age,gender,hypertensive history,diabetes mellitus history,smoking status,blood pressure,heart rate,white blood cell count (WBC), low density lipoprotein-cholesterol (LDL-C), fasting plasma glucose (FPG), Killip class,the lesion count, and the incidence of in-hospital major adverse cardiovascular events (MACE) was also compared. Multivariate logistic regression analysis was used to analyze the influencing factors of intra-operative no-reflow of acute STEMI patients treated with primary PCI. Results The leukocyte count, serum creatinine,the incidence of Killip class ≥ three and in-hospital MACE in group B was significantly higher than that in group A. Multivariate Logistic regression analysis showed that,leukocyte count(OR 1.220,95%CI 1.064-1.399,P=0.004), Killip class(OR 4.617,95%CI 1.093-2.095,P=0.037)were independent risk factors of intra-operative no-reflow of acute STEMI patients treated by primary PCI. Conclusion leukocyte count was an independent risk factor of intra-operative no-reflow of acute STEMI patients treated by primary PCI.

Key words: myocardial infarction, leukocyte, no-reflow, ischemia-reperfusion injury, percutaneous coronary intervention(PCI)

中图分类号:

R542.2⁺2

吴晴晴, 华琦, 薛淞, 张迎花, 司瑾, 李静. 白细胞计数与急性ST段抬高型心肌梗死病人直接经皮冠状动脉介入术中无复流的关系[J]. 首都医科大学学报, 2017, 38(3): 372-376.

Wu Qingqing, Hua Qi, Xue Song, Zhang Yinghua, Si Jin, Li Jing. Relationship between white blood cell count and intra-operative no-reflow of acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention[J]. Journal of Capital Medical University, 2017, 38(3): 372-376.

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白细胞计数与急性ST段抬高型心肌梗死病人直接经皮冠状动脉介入术中无复流的关系

Relationship between white blood cell count and intra-operative no-reflow of acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

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