摘要
目的探讨急性ST段抬高型心肌梗死患者载脂蛋白A-1(ApoA-1)与心肌损伤的相关性。方法回顾性分析天津医科大学沧州市中心医院教学医院心内科自2018年10月至2020年8月收治的112例行急诊经皮冠状动脉介入治疗的急性ST段抬高型心肌梗死患者的临床资料。根据ApoA-1数值将患者分为低三分位组(ApoA-1≤0.94 g/L,n=39)、中三分位组(0.94 g/L1.14 g/L,n=37)。记录并比较3组患者的实验室指标、介入指标、心脏磁共振指标。分析ApoA-1与梗死面积(IS)、微循环阻塞、濒危心肌面积、心肌挽救指数及心肌内出血的相关性。采用单因素与多因素线性回归模型分析急性ST段抬高型心肌梗死患者IS的影响因素。采用受试者工作特征(ROC)曲线评估ApoA-1对心肌损伤的预测价值。结果中三分位组、高三分位组的高密度脂蛋白均高于低三分位组,差异均有统计学意义(P<0.05)。高三分位组的左室射血分数高于低三分位组,左室舒张末期内径低于低三分位组,差异均有统计学意义(P<0.05)。相关性分析提示,ApoA-1与IS呈负相关性(r=-0.500,P<0.05)。多因素线性回归分析显示,ApoA-1为急性ST段抬高型心肌梗死患者IS的独立保护因素(P<0.05)。ApoA-1预测发生严重梗死的ROC曲线下面积为0.717(95%可信区间0.622~0.812,P<0.05)。结论急性ST段抬高型心肌梗死患者ApoA-1水平为IS的独立预测因素。
Objective To investigate the correlation between apolipoprotein A-1(ApoA-1)and myocardial injury in patients with acute ST segment elevation myocardial infarction.Methods Clinical data of 112 patients with ACUTE ST-segment elevation myocardial infarction who received emergency coronary intervention in the Department of Cardiology,Teaching Hospital of Tianjin Medical University Cangzhou Central Hospital from October 2018 to August 2020 were retrospectively analyzed.According to apoA-1 values,the patients were divided into the low tertile group(APOA-1≤0.94 g/L,n=39),the middle tertile group(0.94 g/L1.14 g/L,n=37).The laboratory indexes,interventional indexes and cardiac magnetic resonance indexes were recorded and compared among the 3 groups.The correlation of ApoA-1 with infarct size(IS),microcirculation obstruction,area at risk,myocardial salvage index and intramyocardial haemorrhage was analyzed.Univariate and multivariate linear regression models were used to analyze the influencing factors of IS in patients with acute ST-segment elevation myocardial infarction.The predictive value of ApoA-1 in myocardial injury was evaluated by receiver operating characteristic(ROC)curve.Results The high density lipoprotein in the middle and high tertile groups was higher than that in the low decile group,with statistical significance(P<0.05).The left ventricular ejection fraction of the high decile group was higher than that of the low tertile group,and the left ventricular end-diastolic diameter was lower than that of the low tertile group,with statistical significance(P<0.05).Correlation analysis showed that ApoA-1 was negatively correlated with IS(r=-0.500,P<0.05).Multivariate linear regression analysis showed that APOA-1 was an independent protective factor for IS(P<0.05).The area under the curve of apoA-1 for predicting severe infarction was 0.717(95%confidence interval 0.622-0.812,P<0.05).Conclusion ApoA-1 level was an independent predictor of IS in patients with acute ST-segment elevation myocardial infarction.
作者
高光仁
李毅
冯连荣
付金国
王磊
张军
GAO Guang-ren;LI Yi;FENG Lian-rong;FU Jin-guo;WANG Lei;ZHANG Jun(Department of Cardiology,Teaching Hospital of Tianjin Medical University Cangzhou Central Hospital,Cangzhou 061000,China;Department of Neurology,Teaching Hospital of Tianjin Medical University Cangzhou Central Hospital,Cangzhou 061000,China;Department of Cardiology,General Hospital of Northern Theater Command,Shenyang 110016,China)
出处
《临床军医杂志》
CAS
2021年第8期890-893,896,共5页
Clinical Journal of Medical Officers
基金
沧州市重点研发计划指导项目(204106134)。
关键词
载脂蛋白A-1
梗死面积
急性ST段抬高型心肌梗死
心肌挽救指数
心肌损伤
心脏磁共振
Apolipoprotein A-1
Infarct Size
Acute ST-segment elevation myocardial infarction
Myocardial Salvage Index
Myocardial injury
Cardiac magnetic resonance
