ApoA-1水平与老年急性心肌梗死患者心梗后院内心衰的相关性  

Association of ApoA-1 Levels with In-hospital Heart Failure after Myocardial Infarction in Elderly Patients with Acute Myocardial Infarction

作　　者：梁霄 刘韧 张杰[1] 罗亚 秦玲[1] 徐敏[1] LIANG Xiao;LIU Ren;ZHANG Jie;LUO Ya;QIN Lin;XU Min(Department of Cardiology,The First People's Hospital of Zunyi,Zunyi 563099,China)

机构地区：[1]遵义市第一人民医院心内科,遵义563099

出　　处：《微循环学杂志》2024年第1期31-35,共5页Chinese Journal of Microcirculation

基　　金：贵州省卫生健康委科学技术基金(gzwkj2023-305);遵义市科学技术厅市级联合科技计划项目(2018-172号)。

摘　　要：目的:探讨老年急性心肌梗死患者住院期间血清载脂蛋白A-1(ApoA-1)水平与早发心梗后心衰的关系。方法:回顾性收集我院2020-01—2021-04诊断为急性心肌梗死的老年患者207例,根据患者是否发生心衰将其分为心衰组(n=93)和非心衰组(n=114),比较两组患者临床基线资料(年龄、性别、既往病史等)及生化指标(血脂、肾功能)的差异。采用Logistic回归分析ApoA-1与老年急性心梗后心衰的相关性。运用ROC曲线评价ApoA-1和其它相关指标对老年患者早发心梗后心衰的预测效能。结果:与非心衰组患者比较,心衰组患者总胆固醇、高密度脂蛋白胆固醇以及ApoA-1水平均降低(P<0.05);多因素Logistic回归分析结果显示ApoA-1和NT-proBNP与老年患者早发心梗后心衰的发生独立相关(P<0.05);ROC曲线分析结果表明ApoA-1和NT-proBNP预测老年患者早发心梗后心衰事件的AUC分别为0.624(95%CI:0.547-0.702,P<0.01)和0.749(95%CI:0.680-0.819,P<0.01),当二者联合应用后其预测效能提升(AUC=0.780, 95%CI:0.714-0.846,P<0.01)。结论:ApoA-1和NT-proBNP可用于预测老年急性心梗后住院期间心衰事件的发生,并且与心衰事件独立相关。Objective:To investigate the relationship between serum apolipoprotein A1(ApoA-1)levels during hospitalization and early post-myocardial infarction heart failure in elderly patients.Method:A retrospective collection of 207 elderly patients(≥60 years)diagnosed with acute myocardial infarction in our hospital from January 2020 to April 2021 was conducted.The patients were divided into heart failure group(n=93)and non-heart failure group(n=114)based on the occurrence of heart failure.Differences in clinical baseline data(age,gender,medical history,etc.)and biochemical parameters(lipid profile,renal function,etc.)between the two groups were compared.Logistic regression analysis was used to evaluate the correlation between ApoA-1 and early post-myocardial infarction heart failure in elderly patients.ROC curve analysis was performed to assess the predictive efficacy of ApoA-1 and other related indicators for early post-myocardial infarction heart failure in elderly patients.Results:Compared with the non-heart failure group,the heart failure group had significantly lower levels of total cholesterol,high-density lipoprotein cholesterol,and ApoA-1(P<0.05).Multivariate logistic regression analysis showed that ApoA-1 and NT-proBNP were independently and negatively correlated with the occurrence of early post-myocardial infarction heart failure in elderly patients(P<0.05).ROC curve analysis revealed that the AUCs of ApoA-1 and NT-proBNP in predicting early post-myocardial infarction heart failure events in elderly patients were 0.624(95%CI:0.547-0.702,P<0.01)and 0.749(95%CI:0.680-0.819,P<0.01)respectively,and their predictive efficacy significantly improved when combined(AUC=0.780,95%CI:0.714-0.846,P<0.01).Conclusion:ApoA-1 and NT-proBNP can be used to predict the occurrence of early post-myocardial infarction heart failure in elderly patients,and were independently associated with it.

关 键 词：载脂蛋白A-1 急性心肌梗死 心力衰竭 病例对照研究 

分 类 号：R541.4[医药卫生—心血管疾病]