叶士勇 胡武明 向贻佳 曾春来 韦铁民

[摘要] 目的 探討白细胞与钾离子联合辅助诊断ST段抬高型心肌梗死（STEMI）患者的效果分析。 方法 回顾性分析我院2015年9月～2016年8月收治的116例心肌梗死患者及同期来我院体检的50例健康体检者的临床资料，比较各组白细胞、钾离子情况及与病情的关系。 结果 STEMI组患者的白细胞总数明显比非ST段抬高型心肌梗死（NSTEMI）组和对照组患者多，血钾水平明显比NSTEMI组和对照组患者低（P<0.05）；NSTEMI组患者的白细胞总数明显比对照组患者多（P<0.05），但两组的血钾水平差异无统计学意义（P>0.05）。低血钾组患者的白细胞总数明显比高血钾组患者多，低血钾组患者发病至入院时间明显比高血钾组患者短（P<0.05）。Pearson相关分析结果表明，STEMI组患者的血钾水平和白细胞总数呈负相关关系（r=-0.126，P<0.05），血钾水平和发病至入院时间呈正相关关系（r=0.756，P<0.05）。 结论 白细胞与钾离子联合辅助诊断ST段抬高型心肌梗死患者的效果良好，白细胞与钾离子水平可以作为评估病情的指标。

[关键词] ST段抬高型心肌梗死；白细胞；钾离子；联合辅助诊断

[中图分类号] R542.22 [文献标识码] B [文章编号] 1673-9701（2018）02-0031-03

[Abstract] Objective To investigate the efficacy of leucocyte combined with potassium ion in the diagnosis of patients with ST-elevation myocardial infarction（STEMI）. Methods The clinical data of 116 patients with myocardial infarction admitted from September 2015 to August 2016 in our hospital and 50 healthy people in our hospital during the same period were retrospectively analyzed. The leukocytes， potassium ions and the relationship with the disease between groups were compared. Results The total number of leukocytes in patients with STEMI was significantly higher than that in patients with non-ST-segment elevation myocardial infarction（NSTEMI） and the control group（P<0.05）. The level of serum potassium in patients with STEMI was significantly lower than that in NSTEMI group and the control group（P<0.05）. The total number of leukocytes in the NSTEMI group was significantly greater than that in the control group（P<0.05）. However， there was no significant difference between the two groups in the level of serum potassium（P>0.05）. The total number of leukocytes in the hypokalemia group was significantly higher than that in the hyperkalemia group， and the duration from the onset to admission in the hypokalemia group was significantly shorter than that in the hyperkalemia group（P<0.05）. The results of Pearson correlation analysis showed that there was a negative correlation between plasma potassium level and total leukocyte count in STEMI group（r=-0.126， P<0.05）. And there was a positive correlation between plasma potassium level and the time from onset to admission（r=0.756， P<0.05）. Conclusion The combination of leukocytes and potassium ions in the diagnosis of patients with ST-elevation myocardial infarction has a good effect. Leukocyte and potassium levels can be used as indicators to evaluate the condition of disease.

[Key words] ST-segment elevation myocardial infarction； Leukocytes； Potassium ion； Combined auxiliary diagnosis

医学研究[1-3]表明STEMI患者的复发性心脏病事件、短期和长期病死率受到白细胞计数上升的直接而深刻的影响，临床要想有效判断STEMI患者的病情进展，可以通过分析STEMI患者入院时白细胞计数。同时国内外的医学研究还表明[4-6]，低血钾症普遍存在于STEMI患者中。为了对早期ST段抬高型心肌梗死进行及早诊断，从而为患者赢取最佳的治疗时机，本研究探讨了早期ST段抬高型心肌梗死患者行白细胞与钾离子联合辅助诊断的效果，现报道如下。

1 资料与方法

1.1 一般资料

选取我院心内科2015年9月～2016年8月收治的116例急性心肌梗死患者，排除合并有急性感染疾病、急性肺栓塞、脑血管意外、甲状腺功能障碍、电解质代谢紊乱、严重肝肾功能障碍、恶性肿瘤等疾病影响钾离子浓度与白细胞总数的患者。……