摘要
目的 本研究旨在探讨血清不对称二甲基精氨酸(ADMA)与服用质子泵抑制剂(PPI)后初次发生急性冠状动脉综合征(ACS)的关系。方法 研究纳入2017 年1 月至2018 年10 月因初次发生ACS 入住徐州医科大学附属淮安医院的患者及体检中心同期健康体检者共210 例,分为3 组,PPI 组(服用PPI +初次发生ACS)患者70 例,其中男性51 例,女性19 例,平均年龄为(62.80±11.87)岁;ACS 组(未服用PPI +初次发生ACS)患者70 例,其中男性55 例,女性15 例,平均年龄为(62.66±12.13)岁;对照组为同期健康体检患者(未服用PPI +未发生ACS)70 人,其中男性54 人,女性16 人,平均年龄为(62.96±9.09)岁。采用酶联免疫吸附法检测血清ADMA 浓度,同时测量总胆固醇、三酰甘油等指标。采用单因素方差分析、非参数检验和χ2 检验比较3 组研究对象一般人口学信息、各项生化指标及ADMA 水平;组间两两比较采用Mann-Whitney U 检验;采用Spearman 相关分析分析血清ADMA 水平与ACS 传统危险因素的关系;采用多因素Logistic 回归分析探讨ACS 的独立危险因素。结果 PPI 组和ACS 组的血清ADMA 水平均高于对照组,差异均有统计学意义(Z=-9.585、-4.793,P 均< 0.001);PPI 组的血清ADMA 水平高于ACS 组,差异具有统计学意义(Z=-8.750,P < 0.001);PPI 组和ACS 组(即ACS 患者)的血清ADMA 水平与年龄、性别、BMI、吸烟、糖尿病、高血压、总胆固醇、三酰甘油无相关性(P 均> 0.05);Logistic 回归分析显示血清ADMA 水平是初发ACS 患者的独立危险因素(β=0.017,OR=1.017,P < 0.001)。结论 服用PPI 后初次发生ACS 患者的血清ADMA 水平明显高于未服用PPI 的初次发生ACS 患者;初次发生ACS 患者的血清ADMA 水平明显高于健康对照者;血清ADMA 升高是初次发生ACS 的独立危险因素。
Objective To analyze the relationship between serum asymmetric dimethylarginine (ADMA) and initial acute coronary syndrome (ACS) after taking a proton pump inhibitor (PPI). Methods From January 2017 to October 2018, we enrolled 140 patients with initial ACS and 70 healthy subjects. Among them, 70 patients were included in a PPI group (administration of PPI + initial ACS), 70 patients in an ACS group (non-PPI + initial ACS), and 70 healthy subjects (non-PPI + non-ACS) in a control group. Serum ADMA concentration was measured by enzyme linked immunosorbent assay, and cholesterol and triglyceride were measured routinely. General demographic information, biochemical indicators, and ADMA levels were compared by one-way ANOVA, nonparametric test, and chi-square test. Mann-Whitney U test was used for comparison between groups. Spearman correlation analysis was used to analyze the relationship between serum ADMA level and traditional risk factors of acute coronary syndrome. Multivariate logistic regression analysis was used to investigate the risk factors for ACS. Results Serum ADMA levels in the PPI group and the ACS group were both significantly higher than that in the control group (Z=-9.585,-4.793, P < 0.001). Serum ADMA level in the PPI group was significantly higher than that in the ACS group (Z=-8.750, P < 0.001). Serum ADMA levels of ACS patients (PPI group and ACS group) were not correlated with age, gender, BMI, history of hypertension, history of diabetes, smoking history, TC, or TG (P > 0.05). Logistic regression analysis showed that serum ADMA level was an independent risk factor for patients with initial ACS (β=0.017, OR=1.017, P < 0.001). Conclusions Serum ADMA levels in patients with initial ACS after taking proton pump inhibitors are significantly higher than those in initial ACS patients without taking proton pump inhibitors. Serum ADMA levels in patients with initial ACS are significantly higher than those in healthy controls. Elevated serum ADMA is an independent risk factor for initial ACS.
作者
陈倩倩
马莉
韩成艳
王昌成
Chen Qianqian;Ma Li;Han Chengyan;Wang Changcheng(Department of Gastroenterology, Huai′an Second People′s Hospital,Xuzhou Medical University, Huai′an 223002, China;Department of Laboratory Medicine, Huai′an Second People′s Hospital,Xuzhou Medical University, Huai′an 223002, China)
出处
《中华临床医师杂志（电子版）》
CAS
2019年第6期424-428,共5页
Chinese Journal of Clinicians(Electronic Edition)
基金
二甲双胍用于预防食管癌基础和临床研究(淮安市重点研发计划(社会发展)计划)(HAS2015017)
