【摘要】 目的评价急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)后,中性粒细胞水平与ST段下降幅度(STR)及血浆B型脑利钠肽(BNP)的相关性。方法入选发病12 h内成功接受PCI的STEMI患者195例。PCI术前、术后2 h分别记录18导联心电图,PCI术后12 h进行中性粒细胞计数和BNP水平检测,随访6个月记录主要心脏不良事件(MACE)。根据中性粒细胞水平分为3组:第1组(中性粒细胞<4.78×10~9/L)32例;第2组[中性粒细胞(4.78～8.79)×10~9/L]118例;第3组(中性粒细胞≥8.79×10~9/L)45例。结果第3组PCI术后2 h STR>70%的患者较第1组明显减少(P<0.01);高中性粒细胞(>8.79×10~9/L)血症和高BNP(>580 pmol/L)的患者比例STR>70%组(13.8%;11.1%)比30%～70%组和<30%组(20.96%和33.33%;28.7%和35.3%)均显著增高(均为P<0.01);Logistic回归分析显示第3组中性粒细胞与BNP水平的相关性最为密切(r=0.401,P<0.001);随访6个月第3组MACE的发牛率(13.33%)明显高于第1组(6.25%)和第2组(6.78%)(均为P<0.01),结论 PCI术后中性粒细胞水平与STR和BNP水平密切相关,PCI术后中性粒细胞数早期监测有利于STEMI患者PCI术后心肌组织灌注水平和临床预后的评价。更多还原

【Abstract】 Objective To explore the correlation of postprocedural neutrophil count,ST-segment resolution (STR) and BNP in ST-elevated myocardial infarction (STEMI) patients after percutaneous coronary intervention (PCI). Methods A total of 195 STEMI patients underwent successful PCI procedure were enrolled.Electrocardiograms were recorded before and 2 hours after PCI.Neutrophil counts and BNP were measured within 12 hours after PCI.Main adverse cardiac events (MACE) were also recorded during the follow-up survey at 6 months.According to neutrophil counts after PCI,patients were divided into 3 groups: group 1 (<4.78×10~9/L) ; group 2 (4.78-8.79×10~9/L) and group 3 (>8.79×10~9/L).Results Compared with group 1,patients in group 3 had higher occurrence rate of complete STR (P<0.01).The percentages of high neutrophil and plasma BNP were significantly higher in patients with STR >70% (13.8% and 11.1%) than in patients with STR 30% -70% and STR<30% (20.96% and 33.33%; 28.7% and 35.3%,all P<0.01).Logistic regression analysis showed that postprocedural neutrophil count was positively correlated with level of BNP.Compared with group 1 and 2 (6.25% and 6.78%),patients in group 3 (13.33%) showed higher incidence of MACE at 6 months.Conclusions There is a strong relation between postprocedural neutrophil count and STR or BNP,suggesting the early measurement of postprocedural neutrophil count is helpful in evaluating the reperfusion of myocardium and the prognosis of patients with STEM1.更多还原