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

目的探讨急性心肌梗死(AMI)患者入院后C-反应蛋白(CRP)和白细胞(WBC)计数水平与住院期间死亡的关系。方法以1998年1月到2010年10月期间在苏州大学附属第二医院住院的843例AMI的患者为研究对象,收集患者的人口统计学、生活方式、病史、入院后血压、实验室检查结果等相关资料,采用Logistic回归和Kaplan-Meier生存曲线分析CRP和WBC水平与患者住院期间死亡的关联关系。结果在Logistic回归分析中,经多因素调整后,随着CRP和WBC水平的升高,AMI患者发生死亡的危险性呈逐渐升高的趋势(均为P<0.05)。以CRP和WBC最低分位为参比,最高分位的患者发生死亡的OR值(95%CI)分别是1.82(0.92³.59)和4.49(2.143.59)和4.49(2.14⁹.42)。Kaplan-Meier生存曲线分析结果显示,CRP和WBC正常组的生存率显著高于CRP和WBC异常组(均为P<0.05)。结论 CRP和WBC水平升高与AMI患者住院期间死亡的危险性相关联。

Relationship between C-reactive protein, white blood cell count and in-hospital death in patients with acute myocardial infarction

Objective To explore the association between C-reactive protein （CRP）, white blood cell （WBC） count and in-hospital death in patients with acute myocardial infarction （AMI）. Methods A total of 843 AMI patients consecutively admitted to hospital in the Second Affiliated Hospital of Soochow University from January 1998 to October 2010 were selected as study subjects. Data of demographic characteristics, lifestyle, admission blood pressure, clinical laboratory tests and medical history were collected from all subjects. Multivariate logistic regression analysis and Kaplan-Meier survival curve were used to estimate the association between CRP and WBC count and in-hospital death in AMI patients. Results In the Logistic regression analysis, after adjustment for multiple factors, the risk of in-hospital death was significantly increased （P 〈 0. 05 ） with increased CRP level and WBC count. Compared to lowest quartile of CRP and WBC, odds ratio （95% CI） of death associated with highest quartiles of CRP and WBC were 1.82 （0. 92-3.59） and 4. 49 （ 2. 14-9. 42 ）, respectively. Kaplan-Meier survival curve analysis showed that survival probabilities of normal CRP and normal WBC groups were significantly higher compared to those of abnormal CRP and WBC groups （P 〈 0.05 ）. Conclusions Increased CRP and WBC count is associated with the risk of in-hospital death in AMi patients.