论文部分内容阅读
目的:探讨中性粒细胞对急性ST段抬高型心肌梗死(STEMI)合并糖尿病患者,急诊经皮冠状动脉介入(PCI)术后长期预后的影响。方法:纳入2012年1月至2013年12月间,于北京安贞医院收治的急性STEMI合并糖尿病患者75例,入院行急诊PCI术后(12±2)个月不良心脑血管事件(顽固性心绞痛、非致死性心肌梗死、心源性死亡、缺血驱动血运重建及缺血性脑卒中),探讨中性粒细胞计数对其发生的预测作用。结果:单因素分析显示术后(12±2)个月内发生不良心脑血管事件组白细胞计数[(13.21±3.71)vs.(10.19±2.51)×10~9/L]、中性粒细胞计数[(11.69±2.38)vs.(8.15±2.58)×10~9/L]、谷丙转氨酶[(70.38±25.55)vs.(46.83±25.99)U/L]显著高于对照组(均P<0.05)。红细胞计数[(4.25±0.81)vs.(4.79±0.56)×1012/L],血红蛋白含量[(130.79±20.65)vs.(146.88±15.75)g/L],舒张压[(66±16)vs.(75±11)mm Hg](1mm Hg=0.133k Pa)显著低于对照组(均P<0.05)。多因素Logistic回归分析显示,中性粒细胞计数是不良心脑血管事件发生的独立危险因素(OR=2.095,95%CI:1.108~3.961,P=0.023)。受试者工作特征曲线(ROC曲线)显示的曲线下面积为0.837(95%CI:0.709~0.964,P=0.002),结论:中性粒细胞是急性STEMI合并糖尿病患者急诊PCI术后发生不良心脑血管事件发生的独立预测因素。
Objective: To investigate the effect of neutrophils on the long-term prognosis of acute ST-segment elevation myocardial infarction (STEMI) with diabetes and emergency percutaneous coronary intervention (PCI). Methods: A total of 75 acute STEMI patients with diabetes mellitus admitted to Beijing Anzhen Hospital from January 2012 to December 2013 were included in this study. Adverse cardiopulmonary events (refractory Angina pectoris, non-fatal myocardial infarction, cardiogenic death, ischemia-driven revascularization and ischemic stroke) and to explore the effect of neutrophil count on its occurrence. Results: Univariate analysis showed that the white blood cell count ([(13.21 ± 3.71) vs. (10.19 ± 2.51) × 10 ~ 9 / L] in patients with adverse cardiovascular and cerebrovascular events within 12 ± 2 months postoperatively, neutrophils (11.69 ± 2.38 vs. 8.15 ± 2.58, and 10 to 9 / L, respectively) and alanine aminotransferase (70.38 ± 25.55 vs. 46.83 ± 25.99 U / L) were significantly higher than those in the control group (P <0.05). Red blood cell count (4.25 ± 0.81 vs. 4.79 ± 0.56 × 1012 / L), hemoglobin content (130.79 ± 20.65) vs. (146.88 ± 15.75) g / L and diastolic blood pressure (66 ± 16 vs (75 ± 11) mm Hg] (1mm Hg = 0.133k Pa) were significantly lower than those in the control group (all P <0.05). Multivariate logistic regression analysis showed that neutrophil count was an independent risk factor for adverse cardiovascular events (OR = 2.095, 95% CI: 1.108 ~ 3.961, P = 0.023). The receiver operating characteristic curve (ROC curve) showed an area under the curve of 0.837 (95% CI: 0.709 to 0.964, P = 0.002) .Conclusion: Neutrophils are acute in STEMI patients with diabetes Independent predictors of cerebrovascular events.