急性冠状动脉综合征患者髓过氧化物酶和同型半胱氨酸水平与预后的关系研究  

A study on the relationships between each levels of MPO and Hcy and the prognosis of patients with acute coronary syndrome

作　　者：魏庆民[1] 程敏静[2] 程敏菊[1] 何磊[1] 王世杰[1] 李璞[1] 

机构地区：[1]邢台市人民医院心脏内科,河北邢台054000 [2]河北医科大学第三医院外科,河北石家庄050051

出　　处：《中国医学装备》2018年第1期81-84,共4页China Medical Equipment

基　　金：河北省医学适用技术跟踪项目(GL201684)"MPO联合Hcy在评估急性冠脉综合征患者病变程度中的应用"

摘　　要：目的:探讨髓过氧化物酶(MPO)与同型半胱氨酸(Hcy)水平在急性冠状动脉综合征(ACS)患者中的变化及其与预后的关系。方法:选取经医院冠状动脉造影确诊的120例ACS患者,根据病情的不同,将不稳定性心绞痛(UAP)患者分为UAP组,急性心肌梗死(AMI)患者分为AMI组,每组60例。检测两组患者的MPO和Hcy水平,对所有患者进行6个月的随访,主要不良心脏事件(MACE)的终点事件为再次入院、心源性死亡等心脏不良事件。结果:AMI组的Hcy和MPO检测水平分别为(19.37±6.98)μmol/L和(3680.23±1134.27)pmol/L,均高于UAP组的Hcy(16.34±5.70)μmol/L和MPO(2382.36±1403.32)pmol/L的检测水平;AMI组的冠状动脉狭窄程度积分(Gensini积分)为(49.34±43.17)分低于UAP组的(59.16±45.25)分,两组比较差异均有统计学意义(t=-2.604,t=-2.002,t=2.025;P<0.05)。采用二分类Logistic回归分析,Hcy和MPO水平对ACS患者的近期预后影响呈显著正相关,差异有统计学意义(OR=1.128,OR=1.002;P<0.05)。结论:血清Hcy与血浆MPO水平与ACS患者将来发生MACE呈显著正相关,且其预测能力不受其他危险因素的影响,可有效的预测ACS患者MACE的发生。Objective To investigate the changes of the levels of myeloperoxidase （MPO） and homocysteine （Hcy） in patients with acute coronary syndromes （ACS） and the relationship between their changes and prognosis. Methods： 120 patients with ACS who were confirmed by coronary angiography were divided into unstable angina pectoris （UAP） group （n=60 cases） and acute myocardial infarction （AMI） group （n=60 cases） according to different state of illness. The levels of MPO and Hcy of the two groups were measured, and then 6 month follow-ups were implemented to all of them. The terminal events of major adverse cardiac events （MACE） included readmission, cardiac death and other adverse events. Results： The detection levels of Hcy and MPO in AMI group were （19.37±6.98）μmol/L and （3680.23±1134.27）pmol/L, respectively. And both of them were significantly higher than that （16.34±5.70 μmol/L and 2382.36±1403.32 pmol/L） of UAP group, respectively （t=-2.604, t=-2.002, P〈0.05）. While the coronary artery stenosis integral （Gensini score） of AMI group （49.34 ± 43.17） was significantly lower than that （59.16 ± 45.25） of UAP group （t=2.025, P〈0.05）. Besides, the levels of Hcy and MPO were positive correlations with near-term prognosis of patients with ACS as the results of dichotomy Logistic regression analysis, and the ORs of them were statistically significant （OR=1.128, OR=1.002, P〈0.05）, respectively. Conclusion： Both levels of serum Hcy and plasma MPO of patients with ACS were significantly positive correlation with happening of MACE in future. And their predictive ability was not affected by other risk factors, and they could effectively predict the occurrence of MACE in patients with ACS.[

关 键 词：急性冠脉综合征 髓过氧化物酶 血清同型半胱氨酸 预后 

分 类 号：R541.4[医药卫生—心血管疾病]