接受溶栓治疗的急性心梗患者入院中性粒细胞计数与其远期临床预后的相关性分析(1)
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[摘要] 目的 初步探讨接受溶栓治疗的急性心肌梗死(AMI)患者入院中性粒细胞计数等与其远期临床预后的相关性。方法 本研究连续纳入218例在发病12 h内接受溶栓治疗的AMI患者。出院后随访恶性心脏事件，随访时间为(36±22)个月。 结果 ROC曲线分析显示：中性粒细胞计数≥7.21×109/L是恶性心脏事件的最佳预测因子(敏感度=83%，特异度=54%，曲线下面积=0.70)。Kaplan-Meier心脏事件生存分析显示中性粒细胞计数≥7.21×109/L与恶性心脏事件相关。Cox多因素回归分析显示中性粒细胞计数≥7.21×109/L是远期恶性心脏事件的独立预测因子(OR = 3.9，P = 0.002)。其他预测因子还有年龄≥65岁(OR = 2.4，P = 0.01)，无心肌梗死前心绞痛史(OR = 2.2，P = 0.04)及肌酸激酶(CK)峰值≥4 000 IU/L(OR = 3.5，P = 0.02)。 结论 接受溶栓治疗的AMI患者入院中性粒细胞计数与其远期临床预后独立相关。
[关键词] 冠心病；急性心肌梗死；溶栓治疗；远期预后；中性粒细胞
[中图分类号] R541.4 [文献标识码] A [文章编号] 1674-4721(2012)02(b)-0005-03
Study on the relationship between admission neutrophil count and long-term clinical outcome in patients with acute myocardial infarction treated with fibrinolytic therapy
XUE Bing
The First People′s Hospital of Shangqiu City in Henan Province, Shangqiu 476100, China
[Abstract] Objective To examine the relationship between admission neutrophil count and long-term clinical outcome in patients with acute myocardial infarction (AMI) treated with fibrinolytic therapy. Methods Totally 218 consecutive AMI patients treated with fibrinolytic therapy were enrolled in our study. Adverse cardiac events were recorded during an average follow-up of (36±22) months. Results ROC curve analyzed showed that the value of 7.21×109/L for the neutrophil count was the optimal cutoff to predict long-term cardiac events (sensitivity=83%, specificity=54%, area under the curve=0.70), Kaplan-Meier curves revealed that a neutrophil count≥7.21×109/L was associated with a higher incidence of cardiac events. By multivariate Cox proportional hazards model analyzed, a neutrophil count≥7.21×109/L was an independent predictor of long-term adverse cardiac events (OR = 3.9, P = 0.002), as was age≥65 years (OR = 2.4, P = 0.01), the absence of pre-infarction angina (OR = 2.2, P = 0.04) and peak creatine kinase CK≥4 000 IU/L (OR = 3.5, P = 0.02). Conclusion The admission neutrophil count is independently correlated with long-term outcome in AMI patients treated with fibrinolytic therapy.
[Key words] Coronary heart disease; Acute myocardial infarction; Prognosis; Neutrophil; Fibrinolytic therapy ......
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