血清Perilipin-5水平与青年AMI患者病情严重程度和预后的关系  

Association of serum Perilipin-5 level with disease severity and prognosis in young patients with acute myocardial infarction

作　　者：张俊俊 吴美善 何健 张兰玲 ZHANG Jun-jun;WU Mei-shan;HE Jian;ZHANG Lan-ling(Department of Emergency,Longhua Branch of Shenzhen People's Hospital,Shenzhen,Guangdong,518110,China)

机构地区：[1]深圳市人民医院龙华分院急诊内科,广东深圳518110 [2]深圳市人民医院龙华分院心内科,广东深圳518110

出　　处：《心血管康复医学杂志》2024年第6期693-698,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨血清脂滴包被蛋白5(Perilipin-5)与青年急性心肌梗死(AMI)患者病情严重程度和预后的关系。方法:选择深圳市人民医院龙华分院2011年1月至2021年6月期间收治的青年AMI患者170例(AMI组)和同期健康体检者100例(对照组)。根据冠状动脉病变支数将AMI组分为单支病变组(69例)、双支病变组(54例)和≥3支病变组(47例);根据心功能Killip分级,AMI组分为KillipⅠ级(66例)、KillipⅡ级(58例)、KillipⅢ级(46例)。检测比较各组血清Perilipin-5、心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)水平。AMI组根据一年内是否发生主要不良心血管事件(MACE)分为MACE组(49例)和无MACE组(114例)。采用多因素Logistic回归分析AMI患者PCI术后发生MACE的危险因素。结果:与对照组比较,AMI组血清Perilipin-5水平显著降低,cTnI、CK-MB水平显著升高(P均<0.001);单支组、双支组、≥3支组血清Perilipin-5水平依次显著降低,血清cTnI、CK-MB水平、Gensini评分依次显著升高(P均<0.001);KillipⅠ级、Ⅱ级、Ⅲ级患者血清Perilipin-5水平依次显著降低,血清cTnI、CK-MB水平、Gensini评分依次显著升高(P均<0.001)。多因素Logistic回归分析显示,冠脉病变支数、心功能Killip分级、cTnI、CK-MB、Gensini评分为青年AMI患者PCI术后发生MACE的独立危险因素(OR=1.021~1.159,P<0.05或<0.01),Perilipin-5是其独立保护因素(OR=0.858,P=0.013)。结论:青年AMI患者血清Perilipin-5水平可反映冠脉病变和心功能损伤程度,是此类患者PCI术后MACE发生的独立危险因素。Objective:This study aims to investigate the association of serum Perilipin-5 level with disease severity and prognosis in young patients with acute myocardial infarction(AMI).Methods:A total of 170 young AMI patients admitted in Longhua Branch of Shenzhen People's Hospital between January 2011 and June 2021 were enrolled as AMI group,and another 100 healthy subjects undergoing physical examination simultaneously were regarded as control group.According to number of diseased vessels,AMI group was divided into single vessel coronary disease group(n=69),double vessel coronary disease group(n=54)and≥3 vessel coronary disease group(n=47);according to Killip classification,AMI group was divided into Killip grade I group(n=66),grade II group(n=58)and grade III group(n=46).Serum levels of Perilipin-5,cardiac troponin I(cTnI)and creatine kinase isoenzyme MB(CK-MB)were measured and compared among all groups.According to presence of major adverse cardiovascular events(MACE)within 1 year,AMI group was divided into MACE group(n=49)and no MACE group(n=114).Multivariate Logistic regression was used to analyze risk factors of MACE after PCI in AMI patients.Results:Compared with participants in control group,those in AMI group had significant lower serum Perilipin-5 level,and significant higher cTnI and CK-MB levels(P<0.001 all);serum Perilipin-5 level significantly decreased,and serum cTnI,CK-MB levels and Gensini score significantly increased in the order of single vessel group,double vessel group and≥3 vessels group(P<0.001 all);serum Perilipin-5 level significantly decreased,and serum cTnI,CK-MB levels and Gensini score significantly increased in the order of Killip grade I group,grade II group and grade III group(P<0.001 all).Multivariate Logistic regression analysis indicated that number of diseased vessels,Killip grade,cTnI,CK-MB and Gensini score were independent risk factors of MACE after PCI in young AMI patients(OR=1.021~1.159,P<0.05 or<0.01),while Perilipin-5 was its independent protective factor(OR=0.858,P=0.013

关 键 词：心肌梗死 青年人 预后 

分 类 号：R542.2209[医药卫生—心血管疾病]