摘要
目的探讨急性心肌梗死(acute myocardial infarction, AMI)并发非酒精性脂肪肝(non-alcoholic fatty liver disease, NAFLD)患者血脂、血清炎性因子水平变化,及NAFLD对AMI预后的影响。方法 AMI患者712例,其中350例有NAFLD者为观察组,362例无NAFLD者为对照组。比较2组入院时年龄,性别比例,体质量指数(body mass index, BMI),合并高血压、2型糖尿病情况,ST段抬高型心肌梗死(ST-segment elevation myocardial infarction, STEMI)及非STEMI比率,冠状动脉病变支数,行经皮冠状动脉介入术(percutaneous coronary intervention, PCI)比率,药物治疗情况以及血清肌钙蛋白I(cardiac troponin I, cTnI)、尿酸(uric acid, UA)、同型半胱氨酸(homocysteine, Hcy)、C反应蛋白(C-reactive protein, CRP)、总胆固醇(total cholesterol, TC)、三酰甘油(triacylglycerol, TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol, HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol, LDL-C)、白细胞计数(white blood cell count, WBC),D-二聚体(D-dimer, D-D)、血小板/淋巴细胞比值(platelet lymphocyte ratio, PLR);随访观察主要心脑血管不良事件(major cardiovascular and cerebrovascular adverse events, MACCE)发生率及生存时间;Pearson相关分析SYNTAX积分与UA等指标的相关性。结果观察组BMI[(29.00±1.41)kg/m^2]、合并2型糖尿病比率(60.57%)、SYNTAX积分[(24.50±2.37)分]及血清TC[(5.67±0.63)mmol/L]、TG[(2.31±0.27)mmol/L]、LDL-C[(3.13±0.51)mmol/L]、UA[(502.20±31.51)μmol/L]、Hcy[(16.91±1.85)μmol/L]、CRP[(22.30±0.37)mg/L]、WBC[(13.08±2.09)×10^9/L]、D-D[(1.36±0.32)g/L]、PLR(191.34±8.15)均高于对照组[BMI:(27.00±1.69)kg/m^2,合并糖尿病比率:41.99%,SYNTAX积分:(19.60±3.95)分,TC:(5.02±0.35)mmol/L,TG:(1.91±0.40)mmol/L,LDL-C:(2.38±0.55)mmol/L,UA:(446.20±51.08)μmol/L,Hcy:(13.63±1.50)μmol/L,CRP:(13.20±0.33)mg/L,WBC:(11.16±0.98)×10^9/L,D-D:(0.95±0.26)g/L,PLR:158.85±8.35](P<0.05);2组年龄,性别比例,合并高血压比率,
Objective To investigate the changes of lipid indexes and serum inflammatory cytokines as well as the influence of non-alcoholic fatty liver disease(NAFLD) on acute myocardial infarction(AMI). Methods In 712 patients with AMI, 350 patients were complicated with NAFLD(observation group) and 362 patients were not complicated with NAFLD(control group), and were compared the age, sex ratio, body mass index, complications of hypertension and type 2 diabetes mellitus, percentages of ST-segment elevation myocardial infarction(STEMI) and non-STEMI, coronary artery lesion, percentage of percutaneous coronary intervention(PCI), drug therapy, and the levels cardiac troponin I(cTnI), uric acid(UA), homocysteine(Hcy), C-reactive protein(CRP), total cholesterol(TC), triacylglycerol(TG), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), white blood cell count(WBC), D-dimer(D-D) and platelet lymphocyte ratio(PLR). The incidence of major cardiovascular and cerebrovascular adverse events(MACCE) and survival were followed up. Pearson regression analysis was adopted to analyze the correlation between SYNTAX score and UA. Results BMI((29.00±1.41) kg/m^2), incidence of type 2 diabetes mellitus(60.57%),SYNTAX score(24.50±2.37),serum TC((5.67±0.63)mmol/L),TG((2.31±0.27)mmol/L),LDL-C((3.13±0.51)mmol/L),UA((502.20±31.51)μmol/L),Hcy((16.91±1.85)μmol/L),CRP((22.30±0.37)mg/L),WBC((13.08±2.09)×109/L),D-D((1.36±0.32)g/L)and PLR(191.34±8.15)in observation group were significantly higher than those in control group((27.00±1.69)kg/m2,41.99%,19.60±3.95,(5.02±0.35)mmol/L,(1.91±0.40)mmol/L,(2.38±0.55)mmol/L,(446.20±51.08)μmol/L,(13.63±1.50)μmol/L,(13.20±0.33)mg/L,(11.16±0.98)×109/L,(0.95±0.26)g/L,158.85±8.35)(P<0.05),and there were no significant differences in the age,sex ratio,complication of hypertension,branch of coronary artery lesion,STEMI,non-STEMI,PCI percentage,aspirin application,and serum levels of HDL-C and cTnI between two groups(P>0.05).The incidence of MACCE was higher
作者
陈明
谭强
CHEN Ming;TAN Qiang(Department of Cardiovascular Medicine,the First Hospital of Qinhuangdao,Qinhuangdao 066000,China)
出处
《中华实用诊断与治疗杂志》
2020年第1期33-36,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
河北省科技支撑项目(16277720D)
河北省秦皇岛市科技支撑项目(201602A166)
关键词
急性心肌梗死
非酒精性脂肪肝
炎性因子
acute myocardial infarction
non-alcoholic fatty liver disease
inflammatory cytokine
