摘要
目的探讨急性冠状动脉综合征(ACS)患者经皮冠状动脉介入术(PCI)前后血清缺血修饰清蛋白(IMA)水平变化及其与长期预后的相关性。方法以我院2013年8月到2014年9月收治的200例择期行PCI术的ACS患者为研究对象,根据疾病类型分为不稳定型心绞痛(UAP)组和急性心肌梗死(AMI)组。分析患者临床资料,随访至2017年9月,随访终点为心脏不良事件(MACEs),比较ACS患者PCI术前及术后各时段的IMA水平;采用Logistic回归多因素分析ACS患者发生MACEs的独立危险因素。结果两组患者术后即刻IMA水平高于术前,术后0.5 hIMA水平开始下降,术后6 h下降至正常范围,术后12 h下降至基线水平(P<0.05),两组患者各时段IMA水平比较均无显著差异(P>0.05);随访结束共有94例患者发生MACEs,且MACEs组的IMA水平高于非MACEs组(P<0.05);IMA水平高、冠状动脉病变支数多均是ACS患者长期发生MACEs的独立危险因素(P<0.05),且二者呈正相关关系(r=0.541,P=0.015)。结论 IMA水平在PCI术后即刻迅速上升,但是随着术后时间的推移,其水平逐渐降至正常水平,是ACS患者发生MACEs的独立危险因素,与患者长期预后密切相关。
Objective To investigate the changes of serum ischemic modified albumin levels in patients with acute coronary syndrome before and after PCI and its correlations with long-term prognosis.Methods The clinical data of 200 patients with ACS who had undergone PCI between August 2013 and September 2014 was retrospectively analyzed.Follow-up lasted until September 2017 with the occurrence of MACEs.The IMA levels of patients with ACS before and after PCI were compared,and independent risk factors for MACEs in ACS patients were analyzed by logistic regression.Results Postoperative IMA levels,which were lower in the two groups,began to decrease after half an hour,returned to normal after 6 hours,and decreased to the baseline level after 12 hours(P<0.05).There was no significant difference in IMA levels between the two groups(P>0.05).A total of 94 patients had MACEs by the end of follow-up,and the IMA levels in the MACEs group were higher than those in the non-MACEs group(P<0.05).High IMA levels and the number of coronary artery lesions were independent risk factors for long-term MACEs in ACS patients(P<0.05).There was a positive correlation between IMA levels and coronary artery count(r=0.541,P=0.015).Conclusion IMA levels rise rapidly immediately after PCI.However,with the passage of time,IMA levels gradually return to normal,which is an independent risk factor for ACS patients with MACEs,and closely related to long-term prognosis.
作者
谢晓莉
王山斌
刘昕
XIE Xiaoli;WANG Shanbin;LIU Xin(Department of Cardiology,Hospital 323 of PLA,Xi'an 710000,China)
出处
《解放军预防医学杂志》
CAS
2018年第2期184-187,共4页
Journal of Preventive Medicine of Chinese People's Liberation Army
基金
陕西省社会发展科技攻关项目(No.2015SF060)
