The Study On Relationship Between The Changes Of Leukocytes And Microcirculation And Clinical Significance In Acute Myocardial Infarction Before And After Interventional Therapy

Objective:To investigate the relationship between the changes of leukocytes and microcirculation,further research the clinical significance in acute myocardial infarction interventional therapy.Method:60 patients(male 40,female20,58.31±11.14 years old)with ST segment elevation myocardial infarction(STEMI) from Dec 2006 to Oct 2007 were enrolled.The levels of leukocytes were measuredb efore and 1h,24h,48h,72h after PCI.The extent of the ST segment elevation and resolution in electrocardiograms on admission and 1h,24h,48h,72h after PCI was analyzed.All the patients were divided into two groups according to the extent of ST segment elevation and resolution. GroupA:resolution of ST segments elevation＜50%,n=24;Group B:resolution of ST segment elevation≥50%,n=36.killip class were recorded on admission and one week after PCI.Heart events(heart failure,unstable angina pectoris,recovered AMI,malignant auricular arrhythmia,open heart surgical procedures and death)were recorded 3 months after PCI.Left ventricular eject function(LVEF)and left ventricular end diastolic diameter were measured by echocardiography ten days and three months after PCI.SPECT underwent ten days after PCI. Results:(1)There was no significant difference in position of lesion and number of involved branches.B was better than A in TIMI grade,It had significant difference.(2)B was lower than A in leukocytes on admission,B was obviously lower than A in 1h,24h,48h,after PCI in the inter-group comparison and it had significant difference.There was no significant difference in the intra-group comparison in B group in 1h,24h after PCI but in 48h it was lower than on admission. leukocytes in A group was higher than admission time in 1h,24h after PCI.(3)Leukocytes had very significantly negative correlation with LVEF.(4)There was a positive correlation between ST-segment changes and LVEF 3 month after PCI.(5)LVEF had a improved tendency between two group in 3 month after PCI B group was higher than A group at the same time o' clock. (6)LVEDD in B group was better than A group after PCI.LVEDD reduced 3 month after PCI in the two group(7)Killip class on admission were no statistically significant between A and B.Group B was significantly better than group A in killip class one week after PCI,P＜0.05.Conclusions:(1)There was a positive correlation between ST segment resolution and leukocytes(2)The positive correlation between ST segment resolution predicted there was positive correlation between microcirculation and leukocytes(3)A group compared with B group,the myocardial function was poor and recovery curve was delayed(4)LVEDD in A group was increased after PCI and reduced during follow-up period.But it was worse than B group.(5)The level of leukocytes combined with ST segment changes after PCI could reflect myocardial function after myocardial reperfusion.It had clinical practical value for the evaluation of the early prognosis of the disease and distinction of high-risk patients.