血清同型半胱氨酸水平对急性前壁心肌梗死患者预后的影响  

Effect of serum homocysteine level on prognosis of patients with acute anterior myocardial infarction

作　　者：曾毓平 董家龙 卢佳 王迎春 王珍珍 ZENG Yuping;DONG Jialong;LU Jia;WANG Yingchun;WANG Zhenzhen(Department of Cardiovascular,the First People's Hospital of Nankang District,Ganzhou,Jiangxi,341401,China)

机构地区：[1]赣州市南康区第一人民医院心血管内科,江西赣州341401

出　　处：《当代医学》2023年第27期58-61,共4页Contemporary Medicine

摘　　要：目的探讨血清同型半胱氨酸(Hcy)水平对急性前壁心肌梗死患者预后的影响。方法选取2018年6月至2020年8月在赣州市南康区第一人民医院心血管内科接受治疗的200例急性前壁心肌梗死患者作为研究对象,根据Hcy水平分为Hcy高水平组(≥10μmol/L,n=100)与Hcy正常水平组(<10μmol/L,n=100)。比较两组经皮冠状动脉介入术(PCI)后、出院时、术后1年的血液指标[肌酸磷酸激酶(CK)、肌酸激酶同工酶(CK-MB)、高敏肌钙蛋白T(hs-TnT)]、心功能指标[左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)、左心室舒张末期容积(LVEDV)]、术后1年内主要心血管不良事件(MACE)发生情况及再住院率。结果两组CK水平组间、时间、交互比较差异有统计学意义(P<0.05)。两组CKMB、hs-TnT水平时间比较差异有统计学意义(P<0.05);两组CK-MB、hs-TnT水平时间、交互比较差异无统计学意义。术后1年,Hcy高水平组CK、CK-MB、hs-TnT水平均高于Hcy正常水平组,差异有统计学意义(P<0.05)。两组LVEF、LVEDV、LVESV组间、时间、交互比较差异有统计学意义(P<0.05)。出院时,Hcy高水平组LVEF低于Hcy正常水平组,LVEDV小于Hcy正常水平组,LVESV大于Hcy正常水平组,差异有统计学意义(P<0.05)。术后1年,Hcy高水平组LVEF低于Hcy正常水平组,LVEDV、LVESV均大于Hcy正常水平组,差异有统计学意义(P<0.05)。术后1年,Hcy高水平组心功能分级优于Hcy正常水平组,差异有统计学意义(P<0.05)。Hcy高水平组总MACE发生率、再住院率均高于Hcy正常水平组,差异有统计学意义(P<0.05)。结论高Hcy水平损伤患者心功能,增加患者MACE发生率及再住院率,可影响心脏超声相关参数。Objective To investigate the effect of serum homocysteine(Hcy)level on prognosis of patients with acute anterior myocardial infarction.Methods A total of 200 patients with acute anterior myocardial infarction treated in the cardiovascular Department of the First People's Hospital of Nankang District,Ganzhou City from June 2018 to August 2020 were included as the study subjects,and they were divided into the high level Hcy group(≥10μmol/L,n=100)and the normal level Hcy group(<10μmol/L,n=100)according to the Hcy level.The Blood indexes(creatine phosphokinase[CK],creatine kinase isoenzyme[CK-MB],hypersensitive troponin T[hs-TnT]),cardiac function indexes(left ventricular end-systolic volume[LVESV],left ventricular ejection fraction[LVEF]and left ventricular end-diastolic volume[LVEDV])of the two groups were compared after percutaneous coronary intervention(PCI),at discharge and 1 year after surgery,occurrence of major adverse cardiovascular events(MACE)and readmission rate within 1 year after surgery.Results There were significant differences in CK level between the two groups of group,time points and interaction(P<0.05).There were statistically significant differences in CK-MB and hs-TnT levels between the two groups of time points(P<0.05).There was no significant difference in the level time and interaction of CK-MB and hs-TnT between the two groups of group and interaction.1 year after surgery,the levels of CK,CK-MB and hs-TnT in the high Hcy group were higher than those in the normal Hcy group,and the differences were statistically significant(P<0.05).There were significant differences in LVEF,LVEDV and LVESV between the two groups of time points,group and interaction(P<0.05).At discharge,LVEF,LVEDV and LVESV in the high Hcy level group were lower than those in the normal Hcy level group,and the differences were statistically significant(P<0.05).1 year after surgery,LVEF in the high level of Hcy group was lower than that in the normal level in the Hcy group,and LVEDV and LVESV were higher than those in the n

关 键 词：同型半胱氨酸 急性前壁心肌梗死 心功能 主要心血管不良事件 预后 

分 类 号：R542.22[医药卫生—心血管疾病]