年龄对急性前壁心肌梗死患者介入术后心肌重构的影响  

Effect of age on myocardial remodeling in acute anterior myocardial infarction patients after intervention

作　　者：于铭 王裕星 杨松 刘宝乐 赵心宇 赵镜淋 梅佳杰 刘珍竹[1] 曲鹏[1,3] 牛楠[1] YU Ming;WANG Yuxing;YANG Song;LIU Baole;ZHAO Xinyu;ZHAO Jinglin;MEI Jiajie;LIU Zhenzhu;QU Peng;NIU Nan(Department of Cardiology,the Second Affiliated Hospital of Dalian Medical University,Dalian,Liaoning 116027,China;Department of Cardiology,Xinhua Hospital Affiliated To Dalian University,Dalian,Liaoning 116021,China;Faculty of Medicine,Dalian University of Technology,Dalian,Liaoning 116081,China)

机构地区：[1]大连医科大学附属第二医院心内科,辽宁省大连市116027 [2]大连大学附属新华医院心内科,辽宁省大连市116021 [3]大连理工大学医学部,辽宁省大连市116081

出　　处：《中国动脉硬化杂志》2025年第1期38-44,共7页Chinese Journal of Arteriosclerosis

基　　金：国家自然科学基金重大项目(91739119);国家自然科学基金面上项目(81670406)。

摘　　要：[目的]探究年龄对急性前壁心肌梗死患者经皮冠状动脉介入治疗(PCI)术后心肌重构的影响。[方法]本研究为横断面研究,分析因急性前壁心肌梗死接受PCI术后1、3、6及12个月规律随诊的临床资料。根据患者年龄分为低年龄组(<65岁)及高年龄组(≥65岁),分析两组之间基线资料、生物化学指标、冠状动脉造影情况、炎症因子水平及心脏超声指标的差异,并进行年龄与炎症因子的相关性分析及舒张功能多因素线性回归分析。[结果]共入选急性前壁心肌梗死患者87例,年龄(62±13)岁,其中男性67例(77.0%),低年龄组43例,高年龄组44例。与低年龄组相比,高年龄组C反应蛋白、白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)等炎症因子水平升高,二尖瓣环间隔侧e′、二尖瓣口血流速度E/A、二尖瓣环侧壁侧e′等超声指标降低(P<0.05)。高龄是急性前壁心肌梗死患者PCI术后6个月二尖瓣口血流速度E/A、二尖瓣环侧壁侧e′、二尖瓣环间隔侧e′降低的独立危险因素(P<0.05)。[结论]年龄是急性前壁心肌梗死PCI术后舒张功能减低的独立危险因素,炎症因子IL-1β、IL-6、TNF-α可能在年龄相关的急性前壁心肌梗死PCI术后舒张功能受损中发挥一定的作用。Aim To explore the effect of age on myocardial remodeling after percutaneous coronary intervention(PCI)in patients with acute anterior myocardial infarction.Methods This study was a cross-sectional study analyzing clinical data of regular follow-up at 1,3,6 and 12 months after PCI for acute anterior myocardial infarction.According to the age of the patients,they were divided into a low age group(<65 years old)and a high age group(≥65 years old).The differences in baseline data,biochemical indexes,coronary angiography,inflammatory factor levels,and cardiac ultrasound indexes between the two groups were analyzed,and the correlation analysis between age and inflammatory factors and the multivariate linear regression analysis of diastolic function were performed.Results A total of 87 patients with acute anterior myocardial infarction were selected,aged(62±13)years,including 67 males(77.0%),43 in the low age group and 44 in the high age group.Compared with the low age group,the levels of inflammatory factors such as C-reactive protein,interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)increased in the high age group,while ultrasound indicators such as mitral valve annulus septal e′,mitral valve flow velocity E/A,and mitral valve annulus sidewall e′decreased(P<0.05).Older age was an independent risk factor for a decrease in mitral valve flow velocity E/A,mitral valve annulus sidewall e′and mitral valve annulus septal e′in patients with acute anterior myocardial infarction 6 months after PCI(P<0.05).Conclusion Age is an independent risk factor for reduced diastolic function after PCI in acute anterior myocardial infarction,inflammatory factor such as IL-1β,IL-6 and TNF-αmay play a role in the impaired diastolic function after PCI in age-related acute anterior myocardial infarction.

关 键 词：年龄 急性前壁心肌梗死 经皮冠状动脉介入治疗 舒张功能 

分 类 号：R5[医药卫生—内科学]