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目的:评价急性ST段抬高心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)后中性粒细胞水平与心肌灌注和心功能的相关性。方法:入选发病12 h内195例成功接受PCI的STEMI患者。PCI后12 h进行中性粒细胞计数检测,随访6个月记录心脏不良事件。根据其中性粒细胞水平分为3组:中性粒细胞<4.78×109/L组(A组),32例;中性粒细胞4.78~8.79×109/L组(B组),118例;中性粒细胞>8.79×109/L组(C组),45例。结果:①急诊PCI后B组和C组患者TIMI心肌灌注分级(TMPG)0~1级所占比例高于A组、TMPG达3级所占比例低于A组(均P<0.05);②C组心功能Killp分级≥2级患者所占比例明显高于A组和B组(均P<0.05);③随访6个月时C组心脏不良事件的发生率明显高于A组和B组(均P<0.05)。结论:STEMI患者PCI后中性粒细胞水平越高,心肌灌注越差。PCI后中性粒细胞数早期监测有利于急性心肌梗死患者PCI后临床预后的评价。
PURPOSE: To evaluate the correlation between neutrophil levels and myocardial perfusion and cardiac function after percutaneous coronary intervention (PCI) in patients with acute ST-elevation myocardial infarction (STEMI). METHODS: One hundred and ninety-five STEMI patients who were successfully treated with PCI within 12 hours of onset were enrolled. Neutrophil count was measured 12 h after PCI, and cardiac events were recorded 6 months after PCI. According to the level of neutrophils, they were divided into 3 groups: neutrophils <4.78 × 109 / L group (group A), 32 cases; neutrophils 4.78 ~ 8.79 × 109 / L group (group B) Neutrophils> 8.79 × 109 / L group (C group), 45 cases. Results: ① The rates of TIMI myocardial perfusion grading (TMPG) grades 0 to 1 in patients of group B and group C after emergency PCI were higher than those of group A, and the proportions of patients with grade 3 TMPG were lower than those of group A (all P <0.05); The proportion of cardiac function Killp grade≥2 patients was significantly higher than that of patients in group A and B (all P <0.05); ③The incidence of cardiac adverse events in group C at 6 months after follow-up was significantly higher than those in patients in groups A and B All P <0.05). Conclusion: The higher the level of neutrophils in patients with STEMI after PCI, the worse the myocardial perfusion. The early detection of neutrophil number after PCI is helpful to evaluate the clinical prognosis of patients with acute myocardial infarction after PCI.