白细胞增多与急性心肌梗死冠状动脉病变程度及预后的关系

目的探讨白细胞增多与急性心肌梗死冠状动脉病变程度及预后的关系。方法根据心肌梗死初期白细胞总数将90例急性心肌梗死分为两组,A组:白细胞>10×109/L,48例;B组:白细胞≤10×109/L,42例。将两组冠状动脉造影结果及预后进行比较分析。结果A组多支血管病变27例(占56.3%)、梗死相关血管近端病变38例(占79.2%)、梗死相关血管为回旋支3例(占6.3%)、心力衰竭9例(占18.8%)、严重心律失常16例(占33.3%)、梗死后心绞痛12例(占25%),左室射血分数(46±12)%。B组多支血管病变13例(占30.9%)、梗死相关血管近端病变9例(占21.4%)、梗死相关血管为回旋支9例(占21.4%)、心力衰竭4例(占9.5%)、严重心律失常6例(占14.3%)、梗死后心绞痛5例(占11.9%),左室射血分数(54±9)%。两组分项比较差异有统计学意义。结论急性心肌梗死合并白细胞增多多为多支血管病变,梗死相关血管多为前降支或右冠状动脉近端病变,预后不好。

The relation between the severity of coronary artery disease, prognosis and leukocytosis in acute myocardial infarction

Objective To explore the relation between the severity of coronary artery disease,prognosis and leukocytosis in acute myocardial infarction(AMI).Methods Ninty patients with AMI were divided into two groups(group A:WBC>10×10~9/L,n=48.group B:WBC≤10×10~9/L,n=42) based on WBC counts.Data of coronary angiographic findings and prognosis in both group were compared and analyzed.Results In group A,there were 27 multi-vessel disease(56.3%),38 proximal lesions of infarction related artery(79.2%),3 cases′ infarction related artery in LCX(6.3%),9 cases of heart failure(18.8%),16 cases of serious cardiac arrhythmias(33.3%),12 cases of post-infarction angina pectoris(25%),and left ventricular ejection fraction was(46±12)%.In group B,there were 13 multi-vessel disease(30.9%),9 proximal lesions of infarction related artery(21.4%),9 cases′ infarction related artery in LCX(21.4%),4 cases of heart failure(9.5%),6 cases of serious cardiac arrhythmias(14.3%),5 cases of post-infarction angina pectoris(11.9%),and left ventricular ejection fraction was(54±9)%.There were significant difference in the above index between group A and group B.Conclusion Multivessel disease,proximal lesion of infarction related artery in LAD or RCA,and poor prognosis are mostly found in AMI patients with leukocytosis.