急性心肌梗死后心室重构患者CysC、ANGPTL4水平与心功能的关系及其影响因素分析  

Relationship between CysC,ANGPTL4 and cardiac function in patients with ventricular remodeling after acute myocardial infarction and analysis of influencing factors

作　　者：杜海燕[1] 包秋红[2] 皇甫卫忠[1] 程文俊[1] 贾海玉[2] DU Haiyan;BAO Qiuhong;HUANGFU Weizhong;CHENG Wenjun;JIA Haiyu(Department of General Medicine,First Ward of Geriatric Medical Center,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学附属医院全科医学科,呼和浩特010050 [2]内蒙古医科大学附属医院老年医学中心一病区,呼和浩特010050

出　　处：《疑难病杂志》2019年第12期1189-1194,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：内蒙古自治区卫生和计划生育委员会科研计划项目(201704098)

摘　　要：目的分析急性心肌梗死(AMI)后心室重构患者血清胱抑素C(CysC)、血管生成素样蛋白4(ANGPTL4)水平与心功能的关系,并分析AMI后心室重构的影响因素。方法选取2017年6月-2018年6月内蒙古医科大学附属医院全科医学科收治的AMI患者95例为AMI组,根据是否发生左室重构分为心室重构亚组与非心室重构亚组。另选取同期医院健康体检者100例为健康对照组。对比各组临床资料及心功能指标,分析心室重构患者CysC、ANGPTL4水平与心功能的关系及其危险因素。结果 AMI组最终纳入90例患者,有吸烟史、高血压病史、糖代谢异常病史比例及总胆固醇(TC)、三酰甘油(TG)、空腹血糖(FPG)、CysC水平高于健康对照组(χ^2=15.620、29.959、7.625,t=28.993、16.432、6.356、36.106,P均<0.01),ANGPTL4水平低于健康对照组(t=33.638,P<0.01);左室舒张末期容积(LVEDV)大于健康对照组,LVEF低于健康对照组(t=27.689、39.142,P均<0.01)。心室重构亚组(n=35) CysC、LVEDV水平高于/大于非心室重构亚组(n=55)(t=10.670、3.276,P均<0.01);ANGPTL4、LVEF低于非心室重构亚组(t=6.286、4.276,P均<0.01)。CysC水平与LVEDV呈正相关(r=0.612,P<0.05),与LVEF呈负相关(r=-0.570,P<0.05);ANGPTL4水平与LVEDV呈负相关(r=-0.631,P<0.05),与LVEF呈正相关(r=0.578,P<0.05)。Logistic多因素回归分析结果显示,高水平的CysC和低水平的ANGPTL4是心室重构发生的独立危险因素(OR=1.672,95%CI 1.229~2.275;OR=1.405,95%CI 1.059~1.864,P均<0.05)。结论高水平的CysC和低水平的ANGPTL4是AMI后心室重构发生的独立危险因素,且与心功能变化有关。Objective To analyze the relationship between serum cystatin C(CysC),angiopoietin-like protein 4(ANGPTL4) levels and cardiac function in patients with ventricular remodeling after acute myocardial infarction(AMI),and analyze the influencing factors of ventricular remodeling after AMI.Methods Ninety-five patients with AMI treated from June 2017 to June 2018 in the General Medical Department of the Affiliated Hospital of Inner Mongolia Medical University were selected as the AMI group.According to whether left ventricular remodeling occurred,it was divided into ventricular remodeling subgroup and non-ventricular remodeling subgroup.Another 100 healthy people were selected as the healthy control group.The clinical data and cardiac function indexes of each group were compared.To analyze the relationship between CysC and ANGPTL4 levels and cardiac function in patients with ventricular remodeling and its risk factors.Results Ninety patients were finally included in the AMI group.They had a history of smoking,hypertension,a history of abnormal glucose metabolism,and total cholesterol(TC),triacylglycerol(TG),fasting blood glucose(FPG),and CysC levels were higher than those in the healthy control group(χ^2=15.620,χ^2=29.959,χ^2=7.625,t=28.993,t=16.432,t=6.356,t=36.106,P <0.01).The levels of ANGPTL4 was lower than that in control group(t=33.638,P <0.01),The left ventricular end-diastolic volume(LVEDV) was larger than that of the healthy control group(t=27.689,P <0.01).LVEF were lower than those in healthy controls(t=33.638,t=39.142,P <0.01).The levels of CysC and LVEDV in the ventricular remodeling subgroup(n=35) were higher than the non-ventricular remodeling subgroup(n=55)(t=10.670,t=3.276,P <0.01).ANGPTL4 and LVEF were lower than those in the non-ventricular remodeling subgroup(t=6.286,t=4.276,P <0.01).There was a positive correlation between CysC level and LVEDV(r=0.612,P <0.05).It was negatively correlated with LVEF(r=-0.570,P <0.05).ANGPTL4 level was negatively correlated with LVEDV(r=-0.631,P <0.05).Positive corr

关 键 词：心肌梗死 急性 心室重构 胱抑素C 血管生成素样蛋白4 心功能 

分 类 号：R54[医药卫生—心血管疾病]