老年动脉硬化性脑梗死患者白细胞计数与肌钙蛋白 I水平的关系研究

目的：通过检测老年动脉硬化性脑梗死患者外周血白细胞（WBC）计数及心肌肌钙蛋白I（cTnI），探讨WBC计数评价老年动脉硬化性脑梗死患者心功能的临床意义。方法200例老年动脉硬化性脑梗死患者经查血常规后，分为WBC计数正常组和WBC计数增高组，测定其cTnI与血肌酸激酶MB型同工酶（CK-MB），并于住院1周时行超声心动图检查。结果WBC计数增高组cTnI及CK-MB水平均明显高于WBC计数正常组（t＝7．506、10．420，P＜0．01）；WBC计数增高组的窦性心动过速、房室传导阻滞、心房纤颤、室性早搏的发生率明显高于WBC计数正常组（χ2＝4．379、5．563、8．431、11．525，P＜0．05）；WBC计数增高组射血分数（EF）、左室短轴缩短率（FS）均明显低于WBC计数正常组（t＝2．927、2．378，P＜0．05），而左室收缩末期容积（LVESV）、左室舒张末期容积（LVEDV）明显高于WBC计数正常组（t＝2．786、3．404，P＜0．05）。结论WBC计数升高的老年动脉硬化性脑梗死患者，其体内代表心肌损伤和坏死的标记物cTnI及CK-MB也随之升高，炎性反应和心肌损伤加重，恶性心律失常发生率升高。

Relationship of leukocyte count and cardiac troponin I in senile atherosclerotic cerebral infarction

Objective To explore the application value of white blood cell （WBC） count senile atherosclerotic cerebral infarction（ACI） .Methods A total of 200 elderly patients with ACI were enrolled and divided into WBC nor-mal group and WBC increased group ,according to levels of WBC .Levels of cardiac troponin I（cTnI） and blood crea-tine kinase MB isoenzyme（CK-MB） were measured ,and echocardiography examination was performed one week after hospitalization .Results Levels of cTnI and CK-MB in WBC increased group were significantly higher than WBC nor-mal group（t：7 .506 and 10 .420 ,P〈0 .01） .Incidence of sinus tachycardia ,atrioventricular block ,atrial fibrillation and premature ventricualr contraction in WBC increased group were significantly higher than WBC normal group （χ2 ：4 .379 ,5 .563 ,8 .431 and 11 .525 ,P〈 0 .05） .Levels of ejection fraction and left ventricular fractional shortening in WBC increased group were significantly lower than WBC normal group（t：2 .927 and 2 .378 ,P〈0 .05） ,while levels of left ventricular end-systolic volume and left ventricular end-diastolic volume were significantly higher （t：2 .786 and 3 .404 ,P〈0 .05） .Conclusion Increasing of WBC level could cause the elevation of cTnI and CK-MB levels ,the severity of inflammatory reaction and myocardial injury ,and the incidence of malignant arrhythmia in elderly patients with ACI .