Clinical Significance Of Early Changes Of Peripheral Blood Leukocytes And Subtypes In Patients With Acute Myocardial Infarction

[Background]Acute myocardial infarction is a cardiovascular disease which seriously endangers human health.AMI develops on the basis of coronary atherosclerosis and eventually leads to acute myocardial necrosis.A large number of studies have shown that atherosclerosis is the result of chronic inflammatory response after damage of vascular endothelial cells.Inflammation plays an important role in atheromatous plaque rupture and thrombosis.As an inflammatory cell,leukocytes have found that the subtype neutrophils are significantly increased in AMI patients,and the lymphocytes are significantly reduced,and the ratio of neutrophils to lymphocyte(NLR)is of great value in predicting the occurrence of AMI and assessing the severity of AMI.As research continues to go deep,in recent years,it is reported that a large number of eosinophils have been found in the coronary thrombosis in AMI patients,but the eosinophils in peripheral blood are significantly reduced,suggesting that it may play a role in the formation of thrombus.Based on previous studies,there is a significant increase in neutrophils and reduced in eosinophils in AMI patients.Then the ratio of neutrophils to eosinophils,including two inflammatory variables,changes in AMI patients and is associated with the occurrence of AMI.There are few reports at present.[Objective]To investigate the changes of peripheral blood leucocyte(WBC)and its subtypes in patients with acute myocardial infarction(AMI),The relationship between neutrophils and eosinophil ratio(NER)and acute myocardial infarction(AMI)and the major adverse cardiovascular events(MACE)after PCI in the hospital were preliminarily investigated.[Methods]A retrospective study was performed on 76 patients with Acute myocardial infarction(58 cases were STEMI and 18 cases were NSTEMI)who were treated in The Second Affiliated Hospital of Guangzhou Medical University from February 2017 to August 2017.76 healthy controls were recruited from the same period of time.The correlation between WBC,EOS,EOr,NER and troponin I was analyzed by Spearman rank correlation analysis in group AMI,and the relationship between NER and AMI and the occurrence of short-term MACE after PCI operation was preliminarily analyzed.[Results]1.There was no significant difference in sex ratio and age between the two groups of AMI and healthy people(P > 0.05).AMI group smoking history,hypertension history,diabetes history,white blood cell count,neutrophil absolute value and proportion,neutrophils to eosinophil ratio(NER),neutrophils to lymphocyte ratio(NLR)were higher than normal control group,eosinophil absolute value and proportion,lymphocyte absolute value and proportions were all lower than those of the normal control group,and the difference was statistically significant(P<0.01).2.The white blood cell count,absolute value and proportion of neutrophil,absolte value and proportion of eosinophils,absolute value and proportion of lymphocyte,neutrophils and lymphocyte ratio(NLR),uric acid,triglyceride,low density lipoprotein cholesterol ratio were not statistically significant between the two groups of STEMI and NSTEMI(P>0.05).The ratio of neutrophils to eosinophils(NER)(P<0.05)and troponin I(P<0.01)in STEMI group were higher than those in NSTEMI group,and the difference was statistically significant.3.Using the Spearman rank correlation analysis,the correlation coefficient of WBC and troponin I was r=0.469,P< 0.01.It was considered that there was a significantpositive correlation between WBC and troponin I in AMI patients.The correlation coefficient between EOS and troponin I is r=-0.390,P< 0.01,and it can be considered that there is a significantnegative correlation between EOS and troponin I in patients.The correlation coefficient between EOr and troponin I is r=-0.431,P< 0.01,and it can be considered that there is a significantnegative correlation between EOr and troponin I in patients.The correlation coefficient between NER and troponin I is r=0.451,P< 0.01,and it can be considered that there is a significantpositive correlation between NER and troponin I.4.There was no significant difference in sex ratio,age,white blood cell count,absolute value and proportion of neutrophils,absolute value and proportion of neutrophils,absolute value and proportion of lymphocyte,neutrophils and lymphocyte ratio(NLR),smoking history,hypertension history,diabetes history,infarct related artery,2 or 3 coronary artery lesions between AMI and MACE group and AMI group without MACE(P>0.05).The absolute value and proportion of eosinophils in AMI combined with MACE group were significantly lower than that without MACE,and the ratio of neutrophils and eosinophils(NER)was significantly higher than that in AMI without MACE,and the comparison was statistically significant(P < 0.05).There was a statistically significant difference between the two groups in Killip grade ≥ III level(P<0.01)or coronary artery single vessel disease(P<0.05).[Conclusion]1.The WBC count of AMI patients was significantly higher,and there was a significant positive correlation with the troponin I,and the absolute value and proportion of EOS were significantly reduced and significant negatively correlated with the troponin I,suggesting that WBC and its subtype EOS and AMI are closely related.2.The ratio of neutrophil to eosinophil(NER)in AMI patients is significantly higher,and it has a significant positive correlation with troponin I.NER may be a judging indicator of the early inflammatory response of AMI.It is of certain value for judging the occurrence of AMI and the degree of myocardial damage.3.The NER value in AMI combined MACE group was significantly higher than that in AMI without MACE group,which may be related to short-term prognosis of AMI patients after PCI surgery.