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

摘要

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 noreflow,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.%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.