急性心肌梗死患者白细胞计数与肌钙蛋白I峰值水平的关系

目的观察急性心肌梗死(AMI)患者急性发作期白细胞计数(WBC)与心肌肌钙蛋白I(cTnI)及恶性心律失常发生率的关系。方法收集2007年1月至2012年12月青岛市胶州中心医院收治的发病<3 d的AMI住院患者187例,按WBC水平将其分为三组,WBCⅠ组(<10.0×109L-1)67例;WBCⅡ组(10.0×109L-1¹5.0×109L-1)65例;WBCⅢ组(>15.0×109L-1)55例。测定各组cTnI及血肌酸激酶同工酶MB(CK-MB)水平。结果 AMI患者的cTnI及CK-MB水平随着WBC水平的升高而增高;WBCⅢ组的窦性心动过速、房室传导阻滞、束支传导阻滞、心房颤动、室性期前收缩的发生率显著高于WBCⅠ组和Ⅱ组(P<0.05)。WBCⅠ组、Ⅱ组、Ⅲ组的心律失常总发生率分别为16.4%、43.1%和100.0%,心律失常发生率随着WBC增多而升高,三组心律失常总发生率比较差异有统计学意义(P<0.05)。结论 WBC水平越高的AMI患者cTnI水平越高,心肌损伤越严重,也越容易发生恶性心律失常。

The Relationship between White Blood Cell Count and Troponin I Peak Level in Patients with Acute Myocardial Infarction

Objective To observe the correlation between white blood cell count （WBC）, cardiac troponin I（cTnI） ,and the incidence of malignant cardiac arrhythmias in acute exacerbation of acute myocardial infarction（AMI） patients. Methods A total of 187 AMI cases with onset within 3 d admitted to Qingdao Jiaozhou Central Hospital from Jan. 2007 to Dee. 2012 were collected. The 187 patients were divided into three groups according to the WBC levels. 67 cases in WBC I group（ 〈 10.0 x 10^9 L- 1 ） ,65 eases in WBC Ⅱ group（ 10.0 x 10^9L-1-15.0 x 10^9L-1 ） and 55 cases in WBC 11I group（ 〉 15.0 x 10^9L-1 ）. The values of cTnI and blood creatine kinase MB isocnzyme（CK-MB） were measured in each group. Results In AMI patients cTnI and CK-MB levels increased with the WBC levels and the differences were statistically significant （ P 〈 0.01 ） ; sinus tachycardia, atrioventricular block, bundle branch block, atrial fibrillation, premature ventricular contractions of WBC Ill group were significantly higher than the WBC I and I] group, and the differences were statistically significant （ P 〈 0. 05 ）. Arrhythmia incidence were 16. 4%, 43. 1% and 100.0% in WBC group I , II, m, respectively, increasing along with the WBC increase. The differences of arrhythmia incidence of the three groups were statistically significant （ P 〈 0.05 ）. Conclusion cTnI level increases with WBC increase in AMI patients;the more serious the myocardial injury ,the more prone to malignant arrhythmias.