中青年急性心肌梗死患者急诊PCI术后血清镁水平与预后的相关性分析  

The correlation between serum magnesium level and prognosis in young and middle-aged patients with AMI after emergency PCI

作　　者：李木源 张瑞 刘宝山 李汶珊 王健 Li Muyuan;Zhang Rui;Liu Baoshan;Li Wenshan;Wang Jian(School of Clinical Medicine,Shandong Second Medical University,Weifang 261000,China)

机构地区：[1]山东第二医科大学临床医学院,潍坊261000 [2]山东第二医科大学第一附属医院心内二科,潍坊261000 [3]山东第二医科大学第一附属医院心脏重症与康复科,潍坊261000

出　　处：《中国循证心血管医学杂志》2025年第2期189-194,共6页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：山东省自然科学基金(ZR2021QH262);山东省自然科学基金(ZR2020QH005)。

摘　　要：目的研究中青年急性心肌梗死(AMI)患者接受急诊经皮冠状动脉介入治疗(PCI)术后血清镁离子水平与预后的相关性,为临床对于中青年AMI患者的病情评估和改善预后提供新思路。方法选择山东第二医科大学第一附属医院于2021年1月1日至2021年12月31日期间急诊科收治的年龄18~65岁的中青年AMI患者214例为研究对象,患者入院后均急诊行PCI,根据AMI发作后48~72 h内的血清镁离子水平的四分位数,把患者分为四组,记录一般资料、既往史、AMI相关资料、实验室检查结果及预后情况。比较四组患者组间临床基线资料及预后情况,使用单因素及多因素Logistic回归分析,计算优势比及其95%CI。结果经急诊PCI的AMI患者中,血清镁水平低者其饮酒史、糖尿病病史更多,病情较严重,如Killip分级Ⅱ~Ⅳ级的比例增多,钙离子、肌酸激酶同工酶(CK-MB)更低,低密度脂蛋白(LDL)更高等。低镁是其主要不良心血管事件(MACE)发生增多的独立危险因素:Q1组的MACE发生率是Q4组的12.510倍(P<0.001),Q2组的MACE发生率是Q4组的5.221倍(P=0.005),而Q3组与Q4组相比,无明显统计学差异,未发现低镁与左室射血分数(LVEF)异常有显著相关性。除低镁水平外,病变血管数目、梗死相关动脉(IRA)、处理方式均是MACE发生的独立危险因素。结论在中青年AMI急诊行PCI的患者中,低血清镁水平是其MACE发生的独立危险因素,与LVEF异常无显著相关性。Objective To study the correlation between serum magnesium level and prognosis in young and middle-aged patients with AMI after emergency PCI,and to provide new ideas for clinical evaluation of the condition and improvement of prognosis in young and middle-aged patients with AMI.Methods According to the set inclusion and exclusion criteria,214 young and middle-aged AMI patients aged 18 to 65 years admitted to the Emergency Department of Weifang People's Hospital from January 1,2021 to December 31,2021 were included in the study.All patients underwent emergency PCI after admission.According to the quartiles of serum magnesium levels within 48~72 hours after the onset of acute myocardial infarction,the patients were divided into four groups,and the general data,past history data,AMI-related data,laboratory test results and prognosis of the patients were recorded.Clinical baseline data and prognosis were compared among the four groups,and odds ratios and their 95%confidence intervals were calculated using univariate and multivariate logistic regression.Results Among AMI patients who underwent emergency PCI,those with low serum magnesium levels had more alcohol consumption history,diabetes history,and more severe disease,such as increased proportion of Killip grade II-IV,lower calcium ions,CK-MB,and higher LDL.Low magnesium was an independent risk factor for increased MACE:the incidence of MACE in Q1 group was 12.510 times that in Q4 group(P<0.001),and the incidence of MACE in Q2 group was 5.221 times that in Q4 group(P=0.005),while there was no significant statistical difference between Q3 group and Q4 group,but no significant correlation between low magnesium and LVEF abnormalities was found.In addition to low magnesium levels,the number of diseased vessels,IRA,and management were also independent risk factors for the development of MACE.Conclusions In young and middle-aged patients with AMI undergoing emergency PCI,low serum magnesium levels were an independent risk factor for the development of MACE,but were not

关 键 词：中青年 急性心肌梗死 血清镁 经皮冠状动脉介入治疗 主要心脏不良事件 

分 类 号：R542.22[医药卫生—心血管疾病]