摘要
目的:探讨血清脂滴蛋白-5(perilipin-5)在急性ST段抬高型心肌梗死病变(STEMI)的预后价值。方法:选取2015年1月-2018年1月于我院治疗的120例STEMI老年患者作为研究对象,根据患者入院后次晨空腹血清perilipin-5检测水平中位值将STEMI老年患者分成低表达组(60例)和高表达组(60例)。比较2组患者冠状动脉病变情况、随访1年内病死率及主要心血管不良事件(MACE)发生率。结果:1年内死亡患者血清perilipin-5表达水平显著低于存活患者(P<0.001);与高表达组患者比较,低表达组患者的BMI、TG、TC表达水平偏高,HDL-C表达水平偏低,发病至入院时间更长,Killip心功能分级较高(P<0.05,P<0.001);Cox比例风险模型分析结果显示Killip心功能分级(OR=3.323,95%CI:1.370~8.060)、perilipin-5水平(OR=2.408,95%CI:1376~4.880)、HDL-C水平(OR=2.773,95%CI:1.640~4.689)是影响STEMI老年患者预后的独立危险因素;2组患者接受PCI术比例以及PCI手术类型比较差异无统计学意义(P>0.05),但低表达组患者发生3支血管病变比例明显高于高表达组(P<0.05),且低表达组患者发病后1周、1个月、半年及1年病死率均显著高于高表达组(P<0.05),住院期间心力衰竭发生率显著高于高表达组(26.67%∶11.67%,P<0.05),另外低表达组STEMI老年患者发病后1周、1个月、半年及1年的MACE发生率显著高于高表达组(P<0.05)。结论:血清perilipin-5水平与STEMI老年患者冠状动脉病变程度和近远期预后存在显著相关性,且低perilipin-5水平是STEMI老年患者预后的独立危险因素。
Objective:o investigate the relationship among the level of serum lipid droplet protein 5(perilipin-5),coronary artery disease and the short-term and long-term effects in elderly patients with acute ST-segment elevation myocardial infarction(STEMI).Method:A total of 120 STEMI elderly patients who were treated in our hospital from January 2015 to January 2018 were selected as research subjects.According to the median level of fasting serum perilipin-5 in the morning after admission,patients with STEMI were divided into 60 cases of low expression group and 60 cases of high expression group each.Coronary artery disease,mortality and major cardiac adverse events between the two groups were compared.Result:The level of serum perilipin-5 in patients who died within one year was significantly lower than that in surviving patients(P<0.001);Compared with patients in the low-expression group,patients in the high-expression group showed higher BMI,TG,and TC expression levels,but lower HDL-C expression levels and longer time from onset to admission(P<0.05,P<0.001).Analysis of Cox proportional hazard model showed that Killip cardiac function classification(OR=3.323,95%CI=1.370~8.060),perilipin-5 level(OR=2.408,95%CI:1376~4.880),HDL-C level(OR=2.773,95%CI:1.640~4.689)are independent risk factors affecting the prognosis of STEMI elderly patients.There was no significant difference in the proportion of patients receiving PCI and the type of PCI operation between the two groups(P>0.05),but the proportion of patients with three vascular lesions in the low-expression group was significantly higher than that in the high-expression group(P<0.05).The mortality rate at 1 week,1 month,half a year and 1 year after the onset in the low-expression group was significantly higher than that in the high-expression group(P<0.05).he incidence of heart failure during hospitalization in the low-expression group was significantly higher than that in the high-expression group(26.67%:11.67%,P<0.05).Besides,the incidence of STEMI,the incidence of majo
作者
齐明旭
马小峰
谭剑凯
QI Mingxu;MA Xiaofeng;TAN Jiankai(Department of Cardiology,Nanhua Hospital,University of South China,Hengyang,Hunan,421000,China)
出处
《临床心血管病杂志》
CAS
北大核心
2020年第8期713-718,共6页
Journal of Clinical Cardiology
基金
湖南省科技创新计划(No:2018SK51704)。
关键词
脂滴蛋白5
急性ST段抬高
心肌梗死
预后
相关性
perilipin-5
acute ST segment elevation
myocardial infarction
prognosis
correlation
