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目的探讨老年急性ST段抬高心肌梗死患者人院时白细胞计数与心脏不良事件发生及心肌组织水平灌注状态的关系。方法对2002年3月至2004年5月在我院因ST段抬高心肌梗死患者连续行直接PCI的101例老年患者于入院时立即取外周血查血常规,白细胞计数10×10~9/ L为分界点,将患者分为高WBC组和低WBC组,直接PCI术后监测心电图抬高的ST段回落≥50%的时间。观察住院及随访期间发生的重大心脏事件的情况。结果(1)高白细胞组48例,发病6个月至1年发生不良事件25例(52．1%),低白细胞组为53例,不良事件发生12例(22．6%)．两组差异有统计学意义(P＜0．01)；(2)低白细胞组45例(93．7%)PCI术后60 min内ST段回落≥50%,高白细胞组23例(43．3‰)≥50%,两组比较差异有统计学意义(P＜0．01)。结论入院时白细胞计数与老年人心肌梗死预后有关,与心肌组织水平灌注状态也有一定的相关性。
Objective To investigate the relationship between white blood cell count and cardiac adverse events and myocardial perfusion in elderly patients with acute ST-segment elevation myocardial infarction. Methods From March 2002 to May 2004 in our hospital for ST-elevation myocardial infarction in patients with continuous PCI of 101 cases of elderly patients admitted to hospital immediately take routine blood tests, white blood cell count 10 × 10 ~ 9 / L as the cut-off point, the patients were divided into high WBC group and low WBC group, direct ECG monitoring ST-segment elevation ≥ 50% of the time back. Observe the major cardiac events during hospitalization and follow-up. Results (1) There were 48 cases of high leukocyte group, 25 cases (52.1%) of adverse events occurred 6 months to 1 year after onset, 53 cases of low leucocyte group and 12 cases (22.6%) of adverse events. There were significant differences between the two groups (P <0.01). (2) 45 cases (93.7%) in low leukocyte group had ST-segment regression≥50% within 60 min after PCI, and 23 cases in high leukocyte group (43. 3 ‰) ≥50%, the difference between the two groups was statistically significant (P <0.01). Conclusions The white blood cell count on admission is related to the prognosis of myocardial infarction in the elderly and to the level of myocardial perfusion.