摘要
目的 探讨冠心病患者血清丙氨酸氨基转移酶（ALT）水平与冠状动脉病变严重程度及预后的相关性,以期为冠心病患者的早期诊断及预后提供重要的预测价值.方法 选取行冠状动脉造影明确诊断为冠心病的患者240例.根据冠状动脉造影术后的SYNTAX评分将患者分成三组,分别为低危组（ SYNTAX评分为0～22分, 95例）、中危组（SYNTAX评分为23～32分,88例）、高危组（SYNTAX评分≥33分,57例）.另设同期行冠状动脉造影术未见明确狭窄病变或病变＜50%者60例作为对照组.记录所有入选患者的相关临床资料、生化资料及冠状动脉造影术结果,对所有冠心病患者出院后进行为期1年的随访,记录主要心血管不良事件（MACE）发生情况.结果 ①对照组与冠状动脉病变各亚组的性别构成、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、总胆红素（TBIL）、直接胆红素（DBIL）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、血糖（GLU）之间比较差异有统计学意义（P均＜0.05）,而其他因素如年龄、体质指数（ BMI）、吸烟、高血压、糖尿病、间接胆红素（IBIL）、γ-谷氨酰转移酶（GGT）、碱性磷酸酶（ALP）、肌酐（Cr）、尿素氮（BUN）、尿酸（UA）比较差异未见统计学意义（ P均＞0.05）.冠状动脉病变患者各亚组ALT水平分别为（50.00 ±24.00）、（63.0 ±36.50）、（64.00 ±41.50）U/L,均高于对照组,差异有统计学意义（P＜0.05）,随着冠状动脉病变严重程度的增加ALT水平逐渐升高.在冠状动脉病变组,中危组及高危组患者ALT水平均高于低危组患者（P均＜0.05）,中危组与高危组患者间ALT水平比较差异未见统计学意义（P＞0.05）.②Spearman相关性分析显示,血清ALT水平与GLU、TC、TG、LDL-C呈正相关（P＜0.05）,与HDL-C呈负相关（P＜0.05）.冠状动�
Objective To investigate the relationship between serum ALT levels and the severity and prognosis of coronary lesions , in order to provide important predictive value for early diagnosis and prognosis of patients with coronary heart disease.Methods A total of 240 patients with coronary heart disease were selected.After coronary angiography , the patients were divided into three groups according to the SYNTAX score, they were low-risk group （ SYNTAX score was 0-22）, middle-risk group（ SYN-TAX score was 23-32） and high-risk group （ SYNTAX score was higher than 33 points）.Sixty cases with coronary angiography results of no clear stenotic lesions or the lesions 〈50% were selected as the control group.The clinical data, biochemical data and coronary artery angiography were recorded.All patients with coronary artery disease were followed up for a period of one year after discharge and the occurrence of major adverse cardiac events （ MACE） was recorded.Results ①The differences in sex composition, ALT, AST, TBiL, DBiL, TC, TG, HDL-C, LDL-C, GLU between the control group and each subgroup of coronary lesions were significant （ all P〈0.05） , but the other factors such as age , BMI, smoking, hypertension, diabetes, IBiL, GGT, ALP, BUN, Cr, UA were not significantly different （all P〉0.05）.With the increase of severity of coronary artery lesions , ALT level gradually increased , the ALT level in each subgroup of patients with coronary artery disease were （50.00 ±24.00） U/L, （63.0 ±36.50） U/L, and （64.00 ±41.50） U/L, which were significantly higher than those of the control group, the differences were significant （ P〈0.05）.In the coronary lesions group , the ALT level in the middle-risk group and the high-risk group were higher than those in the low-risk group （ P〈0.05）.There was no significant difference in the ALT level between the middle-risk group and the high-risk group （ P〉0.05）.②Spearman analysis showed that serum ALT level was positively correlated with
作者
周雨菡
李志业
张强
刘英
Zhou Yuhan;Li Zhiye;Zhang Qiang;Liu Ying(Department of Cardiology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China（Zhou YH,Zhang Q,Liu Y;Department of Medical Affairs,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)
出处
《中国实用医刊》
2018年第14期15-19,23,共6页
Chinese Journal of Practical Medicine
