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目的探讨白细胞计数对急性ST段抬高型心肌梗死(STEMI)长期预后的影响。方法选择STEMI患者545例,依据白细胞水平将患者分为A组274例(白细胞≤10.0×10~9/L)和B组271例(白细胞>10.0×10~9/L),比较2组患者住院期间主要不良心脑血管事件(MACCE)、病死率及长期MACCE发生率。结果 A组平均年龄明显高于B组[(63.8±11.4岁)vs(60.4±11.4岁),P=0.001];A组住院期间MACCE发生率明显低于B组(5.1%vs 10.3%,P=0.013)。随访28个月,A组MACCE发生率明显低于B组(12.9%vs 16.9%,P=0.018),全因病死率明显低于B组(2.6%vs 5.7%,P=0.045)。白细胞计数是STEMI患者长期MACCE的独立预测因素(HR=1.166,95%CI:1.104~1.231,P=0.036)。结论白细胞计数升高预示STEMI患者近、远期预后不良。
Objective To investigate the effect of leukocyte count on the long-term prognosis of acute ST-segment elevation myocardial infarction (STEMI). Methods 545 STEMI patients were divided into two groups: 274 cases (white blood cells≤10.0 × 10 ~ 9 / L) and 271 cases (WBC≥10.0 × 10 ~ 9 / L) Major adverse cardiovascular and cerebrovascular events (MACCE), mortality and long-term MACCE incidence during hospitalization. Results The average age of group A was significantly higher than that of group B (63.8 ± 11.4 vs 60.4 ± 11.4, P = 0.001). The incidence of MACCE during hospitalization in group A was significantly lower than that in group B (5.1% vs 10.3%, P = 0.013). After 28 months of follow-up, the incidence of MACCE in group A was significantly lower than that in group B (12.9% vs 16.9%, P = 0.018). All-cause mortality was significantly lower than that in group B (2.6% vs 5.7%, P = 0.045). White blood cell counts were independent predictors of long-term MACCE in patients with STEMI (HR = 1.166, 95% CI: 1.104-1.231, P = 0.036). Conclusion The increase of white blood cell count indicates the short-term and long-term prognosis of STEMI patients.