老年急性冠脉综合征病患血清Hcy、心肌酶谱与冠脉病变程度及短期预后的关系探讨  

The Relationship between Serum Hcy,Myocardial Enzyme Spectrum and the Degree of Coronary Artery Disease and Short-term Prognosis in Elderly Patients with Acute Coronary Syndrome

作　　者：卞漫漫 宋春仙[1] 刘璐 梁会 BIAN Man-man;SONG Chun-xian;LIU Lu;LIANG Hui(Zhengzhou Second People's Hospital,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州市第二人民医院,河南郑州450000

出　　处：《罕少疾病杂志》2023年第12期54-56,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探究老年急性冠脉综合征(ACS)患者血清同型半胱氨酸(Hcy)、心肌酶谱[谷草转氨酶(AST)、磷酸肌酸激酶(CK)、磷酸肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)]与冠脉病变程度及短期预后的关系。方法选取2020年5月至2021年5月郑州市第二人民医院收治的老年ACS患者105例作为观察组,另选取同时段在本院体检的健康志愿者35例作为对照组,采用全自动生化分析仪检测Hcy、心肌酶谱各指标情况。依据病变支数将观察组分为1支、2支、3支以及多支,依据Gensini积分将观察组分为1~4分、5~9分、10~19分以及≥20分,比较不同病变支数、Gensini积分Hcy、ALT、AST、CK、CK-MB以及LDH水平的差异性。对ACS患者随访12个月,记录其主要心血管不良事件(MACE),依据有无MACE发生将其分为事件组和非事件组,对比两组Hcy、心肌酶谱指标水平的差异。结果观察组患者Hcy、AST、CK、CK-MB以及LDH水平均较对照组更高(P<0.05)。在Hcy、AST、CK、CK-MB以及LDH水平的比较上,多支病变﹥3支病变﹥2支病变﹥1支病变;Gensini积分≥20分﹥10~19分﹥5~9分﹥1~4分(P<0.05)。Hcy、AST、CK、CK-MB以及LDH分别均与病变支数呈正相关(r=0.859、0.803、0.568、0.932、0.641,P﹤0.05);Hcy、AST、CK、CK-MB以及LDH分别均与Gensini积分呈正相关(r=0.770、0.779、0.523、0.887、0.653,P<0.05)。本研究105例ACS患者,发生MACE者45例,发生率为42.86%。事件组患者的Hcy、AST、CK、CK-MB以及LDH均较非事件组更高(P<0.05)。结论ACS患者Hcy、AST、CK、CK-MB以及LDH等心肌酶谱指标均与冠脉病变程度呈正相关,随着ACS病情的加剧,上述指标的水平随之升高,患者短期预后越差。Objective To investigate serum homocysteine(Hcy),myocardial enzymes[aspartate aminotransferase(AST),phosphocreatine kinase(CK),phosphocreatine kinase isoenzymes]in elderly patients with acute coronary syndrome(ACS)(CK-MB),lactate dehydrogenase(LDH)]and the degree of coronary artery disease and short-term prognosis.Methods From May 2020 to May 2021,105 elderly ACS patients admitted to Zhengzhou Second People's Hospital were selected as the observation group,and 35 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group,and the automatic biochemical analyzer was used to detect Hcy,Myocardial enzyme spectrum indicators.The observation group was divided into 1 branch,2 branch,3 branch and multiple branches according to the number of lesions,and the observation group was divided into 1-4 points,5-9 points,10-19 points and≥20 points according to the Gensini score.Differences in the number of lesions,Gensini score Hcy,ALT,AST,CK,CK-MB and LDH levels.The ACS patients were followed up for 12 months,their major adverse cardiovascular events(MACE)were recorded,and they were divided into event group and non-event group according to the occurrence of MACE,and the levels of Hcy and myocardial enzymes were compared between the two groups.Results The levels of Hcy,AST,CK,CK-MB and LDH in the observation group were higher than those in the control group(P﹤0.05).In the comparison of Hcy,AST,CK,CK-MB and LDH levels,multi-vessel disease>3-vessel disease>2-vessel disease>1-vessel disease;Gensini score≥20 points>10-19 points>5-9 points>1~4 points(P﹤0.05).Hcy,AST,CK,CK-MB and LDH were positively correlated with the number of lesion branches(r=0.859,0.803,0.568,0.932,0.641,P﹤0.05);Hcy,AST,CK,CK-MB and LDH were respectively It was positively correlated with Gensini integral(r=0.770,0.779,0.523,0.887,0.653,P﹤0.05).Among the 105 ACS patients in this study,45 had MACE,with an incidence rate of 42.86%.The Hcy,AST,CK,CK-MB and LDH in the event group were highe

关 键 词：急性冠脉综合征 老年 血清同型半胱氨酸 心肌酶谱 预后 

分 类 号：R541.4[医药卫生—心血管疾病]