环境臭氧暴露与冠心病的严重程度:天冬氨酸氨基转移酶的预测作用  

Ambient ozone exposure and the severity of coronary heart disease:A predicting role of aspartate aminotransferase

作　　者：刘翠怡 李昭源 赵柏铭 戴钟离 王若男 冯雨嘉 彭爱红 向浩[2] 万静[1] LIU Cuiyi;LI Z haoyuan;ZHAO Boming;DAI Zhongli;WANG Ruonan;FENG Yujia;PENG Aihong;XIANG Hao;WAN Jing(Dept.of Cardiology,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China;School of Public Health,Wuhan University,Wuhan 430071,Hubei,China;Dept.of Orthopaedic Surgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)

机构地区：[1]武汉大学中南医院心内科,湖北武汉430071 [2]武汉大学公共卫生学院,湖北武汉430071 [3]武汉大学中南医院骨科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2024年第5期557-563,共7页Medical Journal of Wuhan University

基　　金：湖北省中医药管理局指导性项目(编号:ZY2023F047)。

摘　　要：目的:探讨臭氧暴露与冠心病严重程度的关系以及天冬氨酸氨基转移酶(AST)的中介作用。方法:回顾性分析武汉大学中南医院2016—2021年行冠状动脉造影的2537例冠心病患者。根据SYNTAX评分将其分为低分组(0~22)和高分组(≥23)。采用Logistic回归用于评估臭氧暴露与冠心病严重程度的关系,线性回归探讨臭氧暴露与AST的关系,中介效应分析评估血清AST在臭氧暴露与冠心病严重程度之间的预测作用。结果:臭氧浓度增加,罹患更严重的冠心病的风险增加(OR=1.072,P<0.05)。老年患者中AST(β=3.622,P<0.05)与臭氧暴露呈正相关。同时AST在臭氧暴露和冠心病严重程度中起中介作用,中介效应量为13.1%。结论:长期臭氧暴露与冠心病的严重程度有关,并且AST可作为臭氧暴露下冠心病严重程度的预测指标。Objective:To explore the relationship between ambient ozone exposure and the severity of coronary heart disease(CHD)and the potential role of aspartate aminotransferase(AST).Methods:We included 2537 CHD patients who had undergone coronary angiography from 2016 to 2021 at the Zhongnan Hospital of Wuhan University.According to the SYNTAX score,they were categorized into low(0-22)or high(≥23)SYNTAX score groups.The logistic regression was used to fit the association between ozone exposure and the severity of CHD.Linear regression was performed to explore the relationship between ozone exposure and biochemical indicators.Mediation analysis was performed to examine the potential effect of AST in the association between ozone exposure and CHD severity.Results:As the ozone concentration increased,the risk of suffering from more severe CHD increased(OR=1.072,P<0.05).AST(β=3.622,P<0.05)was positively correlated with ozone exposure in elderly patients.Mediation analysis showed that AST mediated 13.1%(P=0.045)of the ozoneSYNTAX score association.Conclusion:This study indicated that long-term ozone exposure was associated with the severity of CHD,and serum AST might be used as a predictor of the severity of CHD.

关 键 词：臭氧 冠心病 AST 中介效应分析 

分 类 号：R54[医药卫生—心血管疾病]