C 反应蛋白和白细胞计数与急性心肌梗死患者住院期间死亡的关系研究

摘要

目的：探讨 C 反应蛋白（CRP）和白细胞计数与急性心肌梗死患者住院期间死亡的关系。方法选择保定市第一中心医院2005年5月—2014年5月收治的急性心肌梗死住院患者554例，采用自制调查表收集所有患者信息，主要包括基本资料（包括性别、年龄、血压、血糖及心率）、生化检查指标〔包括高密度脂蛋白胆固醇（ HDL -C）、低密度脂蛋白胆固醇（LDL - C）、总胆固醇（TC）、三酰甘油（TG）、CRP 及白细胞计数〕、日常生活习惯（包括吸烟及饮酒情况）3个方面，分析 CRP 和白细胞计数与急性心肌梗死患者住院期间死亡的关系。结果住院期间，91例患者死亡（死亡组），463例患者存活（存活组），急性心肌梗死患者住院期间病死率为16.43%。两组患者 HDL- C、TC、TG 比较，差异无统计学意义（P >0.05）；死亡组患者年龄大于存活组，男性比例、收缩压、舒张压、吸烟率、饮酒率低于存活组，血糖、心率、LDL - C、CRP、白细胞计数高于存活组（P <0.05）。观察期间，554例急性心肌梗死患者中 CRP 升高者共178例，白细胞计数升高者共163例。入院第1天，白细胞计数升高患者病死率高于白细胞计数正常者，入院第20、40、60、80天，CRP、白细胞计数升高患者病死率分别高于 CRP、白细胞计数正常者（P<0.05）。随着 CRP、白细胞计数升高，急性心肌梗死患者住院期间死亡风险升高（P <0.05），校正性别、年龄及其他因素后仍得到相同结果（P <0.05）。结论随着 CRP、白细胞计数升高，急性心肌梗死患者住院期间死亡风险升高。%Objective To investigate the relationship between CRP,WBC and death during hospitalization in patients with acute myocardial infarction. Methods A total of 554 patients with acute myocardial infarction were selected in the First Central Hospital of Baoding from May 2005 to May 2014,self - made questionnaire was used to collect their clinical data, including gender,age,blood pressure, blood glucose, heart rate, HDL - C, LDL - C, TC, TG, CRP, WBC, and relationship between CRP,WBC and death during hospitalization in patients with acute myocardial infarction was analyzed. Results Of the 554 patients,91 cases died during hospitalization were served as case group,other 463 cases were served as control group,the fatality rate was 16. 43%. No statistically significant differences of HDL - C,TC or TG was found between the two groups(P > 0. 05);age,male proportion,SBP,SDP,smoking rate and drinking rate of case group were statistically significantly lower than those of control group,while blood glucose,heart rate,LDL - C,CRP and WBC of case group were statistically significantly higher than those of control group( P < 0. 05). Of the 554 patients,a total of 178 cases' CRP increased,a total of 163 cases' WBC increased. On the first day of admission,the fatality rate of patients with increased WBC was statistically significantly higher than that of patients with normal WBC( P < 0. 05);on the twentieth day,fortieth day, sixtieth day,eightieth day of admission,the fatality rate of patients with increased CRP or increased WBC was statistically significantly higher than that of patients with normal CRP or normal WBC,respectively(P < 0. 05). With the increasing of CRP or WBC,the mortality risk of patients with acute myocardial infarction increased during hospitalization(P < 0. 05),even after adjusting of gender,age and other influencing factors( P < 0. 05). Conclusion With the increasing of CRP or WBC,the mortality risk of patients with acute myocardial infarction increases during hospitalization.