急性心肌梗死患者心脏瓣膜钙化的相关因素分析  

Related factors of cardiac valve calcification in acute myocardial infarction

作　　者：陈楚云 王娜 于扬[1,2] 范芳芳[1,3] 杨颖[1,2] 张岩[1,3] CHEN Chuyun;WANG Na;YU Yang;FAN Fangfang;YANG Ying;ZHANG Yan(Department of Cardiology;Echocardiography Center Laboratory,Cardiovascular Disease Research Institute;Cardiovascular Disease Research Institute,Peking University First Hospital,Beijing,100032,China)

机构地区：[1]北京大学第一医院心内科,北京100032 [2]北京大学第一医院心血管疾病研究所超声心动图中心实验室 [3]北京大学第一医院心血管疾病研究所

出　　处：《临床心血管病杂志》2024年第9期718-724,共7页Journal of Clinical Cardiology

基　　金：国家重点研发计划项目(No:2021YFC2500503)。

摘　　要：目的:探讨急性心肌梗死(AMI)患者主动脉瓣钙化(AVC)、二尖瓣环钙化(MAC)、心脏瓣膜钙化(CVC)的相关因素。方法:连续入选2010年1月—2018年12月于北京大学第一医院心内科住院并留取生物样本的AMI患者911例,所有研究对象均完成超声心动图钙化评价。按主动脉瓣和二尖瓣环是否钙化对患者进行分组,分别分析AVC和MAC的影响因素。同时将患者分为无瓣膜钙化组、单瓣膜钙化组和双瓣膜钙化组,分析CVC的影响因素。结果:多因素回归分析表明,年龄≥65岁(OR=3.21,95%CI:2.39~4.32,P<0.001)、糖尿病(OR=1.35,95%CI:1.00~1.81,P=0.047)、高血压(OR=1.38,95%CI:1.01~1.89,P=0.046)、肾功能不全(OR=1.74,95%CI:1.08~2.81,P=0.024)与AVC相关;年龄≥65岁(OR=5.37,95%CI:2.91~9.93,P<0.001)、糖尿病(OR=1.83,95%CI:1.10~3.04,P=0.020)、肾功能不全(OR=2.55,95%CI:1.35~4.82,P=0.004)与MAC相关;年龄≥65岁(OR=3.68,95%CI:2.75~4.93,P<0.001)、糖尿病(OR=1.57,95%CI:1.18~2.09,P=0.002)、肾功能不全(OR=2.14,95%CI:1.34~3.41,P=0.001)与CVC相关。结论:年龄、糖尿病及肾功能不全与AMI患者CVC相关,不同瓣膜钙化的相关因素并不完全相同。Objective To investigate the related factors of cardiac valve calcification(CVC), aortic valve calcification(AVC), and mitral annulus calcification(MAC) in acute myocardial infarction(AMI) patients.Methods A total of 911 patients with AMI who were admitted to the Department of Cardiology at Peking University First Hospital from January 2010 to December 2018 were included consecutively. All patients had biological samples, and completed echocardiography calcification evaluation. Patients were grouped according to whether the aortic valve and mitral valve were calcified, then the related factors of AVC and MAC were analysed respectively. Simultaneously, patients were divided into the non-valve calcification group, single-valve calcification group, and double-valve calcification group, and the related factors of CVC were analysed.Results Regression analysis found that age ≥ 65 years old(OR=3.21, 95%CI: 2.39-4.32, P < 0.001), diabetes(OR=1.35, 95%CI: 1.00-1.81, P=0.047), hypertension(OR=1.38, 95%CI: 1.01-1.89, P=0.046), and renal insufficiency(OR=1.74, 95%CI: 1.08-2.81, P=0.024) were associated with AVC;Age ≥ 65 years old(OR=5.37, 95%CI: 2.91-9.93, P < 0.001), diabetes(OR=1.83, 95%CI: 1.10-3.04, P=0.020), and renal insufficiency(OR=2.55, 95%CI: 1.35-4.82, P=0.004) were associated with MAC;Age ≥ 65 years old(OR=3.68, 95%CI: 2.75-4.93, P < 0.001), diabetes(OR=1.57, 95%CI: 1.18-2.09, P=0.002), and renal insufficiency(OR=2.14, 95%CI: 1.34-3.41, P=0.001) were associated with CVC.Conclusion Age, diabetes, and renal insufficiency are associated with AVC in AMI patients. The factors related to calcification of different valves are not completely the same.

关 键 词：心脏瓣膜钙化 主动脉瓣钙化 二尖瓣环钙化 超声心动图 急性心肌梗死 

分 类 号：R542.5[医药卫生—心血管疾病]