血清白蛋白水平与初发急性心肌梗死的相关性研究  

Association between serum albumin level and first-onset acute myocardial infarction

作　　者：夏明 顾剑[1] 张弛[1] 贺永明[1] 杨向军[1] 

机构地区：[1]苏州大学附属第一医院心内科,215000

出　　处：《中华老年心脑血管病杂志》2018年第2期153-157,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探究血清白蛋白水平与初发急性心肌梗死的相关性及强度。方法选择诊断明确的初发急性心肌梗死患者2172例(观察组)和非冠心病患者3395例(对照组),进行横断面研究。运用logistic回归分析不同性别和年龄入选者白蛋白水平与初发急性心肌梗死的相关性。结果观察组血清白蛋白水平较对照组明显降低[中位数,40.0g/L vs 41.4g/L,P=0.000]。以血清白蛋白水平为连续性变量进行分析,多因素校正后,每降低1个标准差(白蛋白水平约4g/L),初发急性心肌梗死风险在总人群OR=1.87(95%CI:1.75~2.01),男性OR=1.85(95%CI:1.71~2.01),女性OR=1.48(95%CI:1.26~1.74)。将血清白蛋白水平五分位作为分类变量纳入回归分析,Q1(≥43.8g/L)为参考,多因素校正后,按年龄分层,年龄<65岁人群初发急性心肌梗死OR(95%CI)值分别为:Q2为1.43(1.12~1.82)、Q3为1.95(1.53~2.47)、Q4为2.52(1.95~3.27)、Q5为4.51(3.40~6.00),年龄≥65岁人群:Q2为1.61(1.04~2.5)、Q3为2.21(1.48~3.31)、Q4为3.34(2.24~4.99)、Q5为4.77(3.22~7.08);按性别分层,男性和女性人群血清白蛋白水平均与心肌梗死风险呈负相关,P趋势<0.01。结论无论在年龄或(和)性别分层中,血清白蛋白水平与初发急性心肌梗死风险均呈负相关,并表现为剂量-效应关系。Objective To study the association between serum albumin level and first-onset AMI. Methods A total of 2172 patients with first-onset AMI served as an observation group and 3395 CHD-free patients served as a control group. The association between serum albumin level and first-onset AMI was analyzed by logistic regression analysis. Results The serum albumin level was significantly lower in observation group than in control group （40.0 g/L vs 41.4 g/L, P= 0. 000）. On a continuous scale,when serum albumin level decreased by 1 standard deviation （-4 g/L）,adjusted OR （95%CI） was 1.87 （1.75--2.01）,1.85 （1.71--2.01）,1.48 （1.26--1.74） for AMI in the total patients,male patients and female patients,respectively. On a categorical scale, Q1 （albumin level -43.8 g/L） was used as reference. Stratifying by age showed that adjusted OR （95-CI） was Q2 1.43 （1.12--1.82）,Q3 1.95 （1.53--2.47）,Q4 2.52 （1.95--3.27）,Q5 4.51 （3.40--6.00） for AMI in patients aged -65 years and was Q2 1.61 （1.04-2.5） ,Q3 2. 21 （1.48-3.31）,Q4 3.34 （2.24--4.99）,Q5 4.77 （3.22-7.08） in patients aged ≥65 years （P-for-trend 0.01）. Stratifying by gender showed that serum albumin level was negatively associated with AMI in both sexes （P-for-trend 〈0. 01）. Conclusions Serum albumin level is negatively associated with the risk of first-onset AMI in a dose-response manner regardless of stratifying by age and/or gender.

关 键 词：血清白蛋白 心肌梗死 冠心病 饮食习惯 

分 类 号：R542.22[医药卫生—心血管疾病]