目的 探讨白细胞计数对急性ST段抬高心肌梗死患者预后的意义。方法 选择2015年11月-2017年1月我院收治的ST段抬高心肌梗死患者127例，根据白细胞水平将患者分为WBC升高组（WBC＜10.0×109/L）69例和WBC正常组（WBC≥10.0×109/L）58例，比较两组患者基线资料，观察两组患者心功能指标、cTnI、CK-MB等指标，并对患者住院期间和出院随访2年期间MACCE发生率和病死率进行比较。结果 两组患者年龄、性别、Killip分级≥Ⅲ级等指标存在统计学差异（P<0.05），空腹血糖、肌酐、收缩压、舒张压、病变血管≥2支无明显差异（P>0.05）。WBC升高组LVEDD、LVESD、LAD均高于WBC正常组，LVEF低于WBC正常组，差异有统计学意义（t=3.182、3.536、4.025、4.317，P<0.05）。WBC升高组cTnI、CK-MB均高于WBC正常组，差异有统计学意义（t=6.493、7.132，P<0.05）。WBC升高组住院期间MACCE发生率（14.49%）、病死率（7.25%）明显高于WBC正常组（12.07%、1.72%），差异有统计学意义（P<0.05）。WBC升高组随访期间病死率（10.14%）明显高于WBC正常组（3.45%），差异有统计学意义（P<0.05）。结论WBC计数可作为STEMI患者死亡的预测因素，也可作为临床上判断STEMI危险分层的简单、快捷参考依据。但STEMI死亡是多因素共同作用的结果，而WBC计数升高的最终意义和机制还需进一步研究。

Objective Investigate the significance of WBC count in the prognosis of patients with acute st-segment elevation myocardial infarction.Methods Choice in November 2015 - January 2017 of our hospital, 127 cases of patients with st-elevation myocardial infarction, according to the level of white blood cell divided the patients into elevated WBC groups (the WBC < 10.0 x 109 / L) in 69 cases, the WBC and normal group (the WBC acuity 10.0 x 109 / L) 58 cases, compared two groups of patients with baseline data, observe two groups of patients with cardiac function index, cTnI and CK - MB index, and the patients during hospitalization and discharge follow-up 2 years MACCE incidence and mortality were compared.Results Two groups of patients' age, gender, Killip class acuity Ⅲ indicators such as statistical differences (P < 0.05), fasting blood glucose, creatinine, systolic pressure, diastolic pressure, lesion blood vessel 2 or more with no significant difference (P > 0.05). LVEDD, LVESD and LAD in the WBC elevated group were all higher than those in the WBC normal group, while LVEF was lower than those in the WBC normal group, with statistically significant differences (t=3.182, 3.536, 4.025, 4.317, P<0.05). CTnI and ck-mb in the WBC elevated group were higher than those in the WBC normal group, with statistically significant differences (t=6.493, 7.132, P<0.05). The incidence of MACCE (14.49%) and mortality (7.25%) during hospitalization in the WBC elevated group were significantly higher than those in the WBC normal group (12.07% and 1.72%), with statistically significant differences (P<0.05). The mortality rate of the WBC group during follow-up was significantly higher (10.14%) than that of the WBC group (3.45%), and the difference was statistically significant (P<0.05).Conclusion WBC count can be used as a prognostic factor for the death of STEMI patients, as well as a simple and quick reference for the risk stratification of STEMI in clinical practice. However, the STEMI death is the result of multiple factors, and the ultimate significance and mechanism of the increased WBC count need to be further studied.