摘要
目的探讨急性心肌梗死(AMI)患者经皮冠状动脉介入术(PCI)术后新发房颤(AF)与炎症因子C反应蛋白(CRP)和白介素17(IL-17)的临床相关性。方法采取前瞻性研究方法,将152例确诊AMI后行PCI的患者按照是否在术后14d内初发AF分为AF组(n=38例)和无AF组(n=114例),运用多因素Logistic回归分析法分析两组患者的临床资料、实验室指标、影像学指标以及住院期间不良心血管事件发生率,并分析影响PCI术后AMI患者新发房颤的危险因素。结果心梗PCI后初发AF的发生率为25%;AF组高血压病病史、心衰病史、年龄、入院时血清CRP、IL-17、氨基末端pro脑钠肽(NT-proBNP)、心肌肌钙蛋白I(cTnI)浓度、发病至导丝通过时间均高于无AF组,左心室射血分数(LVEF)低于无AF组,差异均有统计学意义(P<0.05);罪犯血管为左前降支(LAD)较其它冠脉初发AF发生率高,差异有统计学意义(P<0.05)。Logistic多元回归分析结果示:高血压病病史、心衰病史、年龄、入院时血清CRP、IL-17、NT-proBNP、cTnI浓度、心脏超声中LVEF数值、发病至导丝通过时间、罪犯血管为LAD是AMI患者PCI后初发AF的独立危险因素,其中CRP的OR值为3.224,IL-17的OR值为3.002,具有较高的预测价值。结论CRP、IL-17可作为AMI后行PCI的患者是否初发AF的早期预判和风险评估的指标,对预后及治疗有一定指导价值。
Objective To investigate the clinical correlation between new atrial fibrillation(AF),C-reactive protein(CRP)and interleukin-17(IL-17)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A prospective study was carried out to record the differences in 152 patients who underwent PCI after AMI was confirmed.The patients were divided into AF group(n=38 cases)and no AF group(n=114 cases)according to whether the initial AF occurred within 14 days after surgery.The clinical data,laboratory indicators,imaging indicators and the incidence of adverse cardiovascular events during hospitalization of the patients in the two groups were analyzed by multi-factor logistic regression analysis,and the risk factors affecting the new atrial fibrillation in AMI patients after PCI were analyzed.Results The incidence of initial AF after PCI was 25%.The history of hypertension,history of heart failure,age,serum CRP,IL-17,NT-proBNP,cTnI concentration at admission,the time from onset to passage of guide wire in AF group were all higher than those in no AF group,and LVEF in AF group was lower than that in no AF group,with statistical significance(P<0.05).The incidence of primary AF in criminals with left anterior descending(LAD)was higher than that of other coronary arteries,and the difference was statistically significant(P<0.05).The results of Logistic multiple regression analysis are as follows:History of hypertension,history of heart failure,age,serum CRP,IL-17,NT-proBNP,cTnI concentration on admission,LVEF value in cardiac ultrasound,time from onset to passage of guide wire,and culprit vessel LAD were independent risk factors for the initial onset of AF in AMI patients after PCI,in which the OR value of CRP was 3.224.The OR value of IL-17 is 3.002,which has high predictive value.Conclusion CRP and IL-17 can be used as indicators of early prediction and risk assessment for the initial onset of AF in patients undergoing PCI after AMI,and have certain guiding value for prognosis and trea
作者
李静静
李兆欣
郑琳琳
刘晓源
朱勤伟
LI Jingjing;LI Zhaoxin;ZHENG Linlin;LIU Xiaoyuan;ZHU Qinwei(Department of Emergency,Weifang Hospital of Traditional Chinese Medicine,Weifang 261041,China)
出处
《潍坊医学院学报》
2023年第5期366-368,共3页
Acta Academiae Medicinae Weifang
基金
潍坊市卫生健康委员会资助课题(项目编号:2020W021420)。
