急性心肌梗死患者血清AMPK和PGC-1α水平变化及其与新发心房颤动的关系  

Change of serum AMPK and PGC-1αin patients with acute myocardial infarction and their relationship with new onset atrial fibrillation

作　　者：林艳 但汉良 白杨[2] LIN Yan;DAN Hanliang;BAI Yang(Wuhan Dongxihu District People’s Hospital,Wuhan Hubei 430040,China)

机构地区：[1]武汉市东西湖区人民医院,湖北武汉430040 [2]华中科技大学同济医学院附属同济医院,湖北武汉430030

出　　处：《中国急救复苏与灾害医学杂志》2025年第4期430-434,共5页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨急性心肌梗死(AMI)患者血清腺苷酸活化蛋白激酶(AMPK)和过氧化物酶体增殖活化受体γ辅助活化因子1α(PGC-1α)水平变化及与新发心房颤动(NOAF)的关系。方法选取2020年1月—2022年12月在武汉市东西湖区人民医院诊治的AMI患者245例为研究对象,均在入院时测定血清AMPK、PGC-1α水平,并观察其住院期间是否发生NOAF。对比不同血清AMPK、PGC-1α水平的AMI患者NOAF发生率,分析AMPK、PGC-1α与NOAF的独立关系,并评估两指标预测NOAF的价值。结果245例AMI患者住院期间发生41例NOAF,发生率为16.73%(41/245)。NOAF组血清AMPK、PGC-1α水平低于无NOAF组(P<0.05);AMI患者AMPK与PGC-1α呈正相关(r=0.639,P<0.05)。不同血清AMPK、PGC-1α水平AMI患者NOAF发生率比较,差异有统计学意义(P<0.05),且随着AMPK、PGC-1α水平升高,AMI患者NOAF发生率呈降低趋势。调整混杂因素后AMPK、PGC-1α仍与AMI患者NOAF独立相关(P<0.05)。AMPK、PGC-1α水平联合检测预测NOAF的AUC值高于单独评估的AUC值(Z=6.541,P<0.001;Z=3.087,P=0.002)。结论AMI患者AMPK、PGC-1α低表达与NOAF有关,AMPK诱发NOAF可能与调控PGC-1α有关。Objective To explore relationship between changes in serum adenylate-activated protein kinase(AMPK)and peroxisome proliferator-activated receptor gamma coactivator 1α(PGC-1α)levels and new-onset atrial fibrillation(NOAF)in patients with acute myocardial infarction(AMI).Methods A total of 245 AMI patients diagnosed and treated in Wuhan Dongxihu District People's Hospital from January 2020 to December 2022 were selected as the study objects.Serum levels of AMPK and PGC-1αwere measured on admission.And observe whether NOAF occurs during their hospitalization.To compare the incidence of NOAF in AMI patients with different serum AMPK and PGC-1αlevels,to analyze the independent relationship between AMPK and PGC-1αand NOAF,and to assess the value of the two indexes in predicting NOAF.Results NOAF occurred in 41 of 245 AMI patients during hospitalization,with an incidence of 16.73%(41/245).Comparison of serum AMPK and PGC-1αlevels between the two groups showed that the NOAF group was lower than the non-NOAF group(P<0.05).AMPK and PGC-1αwere positively correlated in AMI patients(P<0.05).There was statistical significance in the incidence of NOAF in AMPK and PGC-1αquartile subgroups(P<0.05).With the increase of AMPK and PGC-1αlevels,the incidence of NOAF in AMI patients tended to decrease(P<0.05).After adjusting for confounding factors,AMPK and PGC-1αwere still independently correlated with NOAF in AMI patients(P<0.05).The AUC value of NOAF predicted by AMPK and PGC-1αcombined detection was higher than the AUC value evaluated separately(Z statistics/P=6.541/<0.001,3.087/0.002).Conclusion The low expression of AMPK and PGC-1αin AMI patients is related to NOAF,and the NOAF induced by AMPK may be related to the regulation of PGC-1α.

关 键 词：急性心肌梗死 新发心房颤动 AMPK PGC-1Α 

分 类 号：R542.22[医药卫生—心血管疾病] R541.75[医药卫生—内科学]