摘要
目的通过检测老年急性ST段抬高型心肌梗死(STEAMI)患者外周血白细胞计数(WBC),探讨WBC与血清心肌肌钙蛋白I(cTnI)水平及心功能的关系。方法选取2010年12月—2012年11月绍兴市人民医院心血管内科收治的STEAMI住院老年患者100例,依据急性发作期WBC水平分为两组,WBC正常组(<10.0×109/L)48例,WBC升高组(≥10.0×109/L)52例。测定两组患者的血肌酸激酶MB型同工酶(CK-MB)及cTnI;并于住院1周左右进行超声心动图检查,测定左室短轴缩短率(FS)、射血分数(EF)、左室舒张末期容积(LVEDV)及左室收缩末期容积(LVESV);统计患者入院2周内心律失常的发生情况。结果 WBC升高组cTnI及CK-MB水平均高于WBC正常组;WBC升高组的窦性心动过速、房室传导阻滞、心房纤颤、室性期前收缩的发生率高于WBC正常组,总的心律失常发生率亦高于WBC正常组;WBC升高组的EF、FS均低于WBC正常组,而LVESV、LVEDV高于WBC正常组,差异均有统计学意义(P<0.05)。结论 WBC水平升高的老年STEAMI患者,反映心肌损伤和坏死的标记物cTnI及CK-MB升高,炎性反应和心肌损伤加重,恶性心律失常发生率升高,对心脏功能具有一定评估价值。
Objective To detect the peripheral blood leukocyte count （WBC） in elderly patients with ST - segment elevation myocardial infarction （STEAM!）, and explore the association of the WBC with serum cardiac troponin I （cTn!） levels and cardiac function. Methods Totally 100 elderly inpatients with STEAMI in the cardiology department of our hospital were enrolled from December 2010 to November 2012. They were divided according their levels of WBC as WBC normal group （n = 48, WBC 〈 10. 0 ×10^9/L） and WBC elevated group （n =52, WBC≥10.0×10^9/L） . They were given tests of blood creatine kinase MB isoenzyme （CK - MB） and cTnI. And about one week after admission, they received the examinations of echocardiography, left ventricular fractional shortening （FS）, left ventricular ejection fraction （EF）, left ventricular end - diastolic volume （ LVEDV） and left ventricular end - systolic volume （LVESV） . Their conditions of arrhythmia within 2 weeks after admission were detected. Results Compared with the WBC normal group, in the WBC elevated group the levels of cTnI and CK - MB were significantly higher, prevalence of sinus tachycardia, atrioventricular block, atrial ibrillation, and ventricular premature beats, as well as the total prevalence of arrhythmia were significantly higher; the parameters of EF, FS were significantly lower, while the values of LVESV, LVEDV were significantly higher （P 〈 0. 05） . Conclusion The elderly patients with STEAMI and elevated WBC have higher levels of cTnI and CK - MB as markers indicating myocardial injury and necrosis, severer inflammatory reaction, and increased incidence of malignant arrhythmia, which has a certain value to cardiac function.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第1期47-49,共3页
Chinese General Practice
关键词
心肌梗死
白细胞计数
心肌肌钙蛋白I
老年
Myocardial infarction
White blood cell count
Cardiac troponin I
Aged
