尿酸和脂联素与急性心肌梗死患者炎性因子水平及介入治疗后发生心力衰竭的关系  

Relationship of serum uric acid and adiponectin with inflammatory factor levels and heart failure after PCI in patients with AMI

作　　者：程云涛[1] 杨光霞[2] 蔺跃栋[1] 张宗雷 郭道通[1] 许朕 杜斌 陈雪英 Cheng Yuntao;Yang Guangxia;Lin Yuedong;Zhang Zonglei;Guo Daotong;Xu Zhen;Du Bin;Chen Xueying(Cardiac Emergency Ward,Department of Cardiology,Affiliated Hospital Jining Medical College,Jining 272000,Shandong)

机构地区：[1]济宁医学院附属医院心内科心脏急诊病区,272000 [2]济宁医学院附属医院呼吸与危重症医学科,272000

出　　处：《中华老年心脑血管病杂志》2023年第7期704-707,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81700230)。

摘　　要：目的探讨急性心肌梗死(AMI)患者血尿酸、脂联素水平与炎性因子水平的相关性,并分析二者与患者PCI后发生心力衰竭的关系。方法选取2019年12月至2021年4月我院心内科收治的AMI患者142例,根据PCI治疗并随访1年内是否发生心力衰竭分为发生组33例和未发生组109例,比较2组一般临床资料,分析术前尿酸、脂联素与炎性因子水平的相关性。结果发生组高敏C反应蛋白(hs-CRP)、TNF-α、白细胞介素6(IL-6)、尿酸水平明显高于未发生组,脂联素水平明显低于未发生组(P<0.01)。PCI术前尿酸与hs-CRP、TNF-α、IL-6呈正相关(P<0.01),脂联素与hs-CRP、TNF-α、IL-6呈负相关(P<0.01);尿酸水平升高是发生心力衰竭的危险因素(P<0.01),术前脂联素升高是保护因素(P<0.05);二者联合检测对AMI患者PCI后发生心力衰竭的ROC曲线下面积为0.900(95%CI:0.842~0.957,P<0.01)。结论术前尿酸、脂联素水平与AMI患者PCI术前炎性因子水平具有相关性,且与患者PCI后发生心力衰竭有关。Objective To investigate the correlation of serum BUA and APN with inflammatory factors in patients with AMI,and to analyze the relationship between them and HF after PCI.Methods A total of 142 AMI patients undergoing PCI in our hospital from December 2019 to April 2021 were enrolled and divided into occurrence group(n=33)and non-occurrence group(n=109)according to whether they had HF within 1 year of follow-up.Their general clinical data were compared,and the correlation of preoperative BUA,APN and inflammatory factors was analyzed.Results Compared with the non-occurrence group,the levels of hs-CRP,TNF-α,IL-6 and BUA were significantly higher,while APN was obviously lower in the occurrence group(P<0.01).BUA was positively correlated with hs-CRP,TNF-αand IL-6 in AMI patients before PCI(P<0.01),and APN was negatively with hs-CRP,TNF-αand IL-6(P<0.01).The higher preoperative level of BUA was risk factors(P<0.01),while higher preoperative APN was protective factor for HF(P<0.05).The AUV value of combined BUA and APN in predicting HF in AMI patients after PCI was 0.900(95%CI:0.842-0.957,P<0.01).Conclusion Preoperative levels of BUA and APN are correlated with the preoperative levels of inflammatory factors in AMI patients after PCI,and are associated with the occurrence of HF after PCI.

关 键 词：心肌梗死 尿酸 脂联素 白细胞介素6 心力衰竭 

分 类 号：R542.22[医药卫生—心血管疾病] R541.6[医药卫生—内科学]