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高同型半胱氨酸对急性心肌梗死患者预后影响的研究

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摘要:

目的 分析高同型半胱氨酸(HHcy)对ST段抬高型急性心肌梗死患者预后的影响。方法 回顾分析2015年6月至2016年12月于中国人民解放军联勤保障部队第九二零医院心血管内科行直接PCI 的ST段抬高型急性心肌梗死患者511例,其中162例资料完整,进入研究。将患者分为HHcy组(Hcy≥15 μmol/L)84例和非HHcy组(Hcy<15 μmol/L)78例;收集患者的基线资料,PCI过程及住院期间的相关 数据和出院6个月内的情况。再将162例患者中合并高血压的98例按同型半胱氨酸(Hcy)水平,分为H 型高血压组48例和单纯高血压组50例,收集资料与上个分组相同。统计分析上述两分组资料数据。结果 HHcy组男性比例、吸烟率、肌酐水平、Hcy浓度及术后服用替格瑞洛比例较非HHcy组高,差异有统计学 意义(P<0.05)。H型高血压组与单纯高血压组比较,男性比例、肌酐水平、Hcy浓度及随访1月再住院 率H型高血压组高于单纯高血压组,差异有统计学意义(P<0.05);Logistic回归分析显示患者1月再住 院发生的主要影响因素为冠心病家族史、Hcy和术前血糖(P<0.05)。结论 H型高血压较单纯HHcy对 急性心肌梗死患者预后的影响更显著,或者HHcy合并高血压时才会对心肌梗死患者产生显著影响。

Abstract:

Objective To analyze the influence of hyperhomocysteinemia (HHcy) on prognosis in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods STEMI patients undergone primary PCI (n=511) were chosen from Department of Cardiology in the 920th Hospital of Chinese PLA Joint Logistics Support Force from June 2015 to Dec. 2016, among them 162 patients with complete data were included the study. All patients were divided into HHcy group (Hcy≥15 μmol/L, n=84) and non-HHcy group (Hcy<15 μmol/, n=78). The baseline materials, and data related to PCI process, hospital stay and hospital discharge within 6 months were collected from the patients. In addition, 98 patients with complicated hypertension from 162 patients were divided, according to Hcy level, into H-type hypertension group (n=48) and isolated hypertension group (n=50). The relevant materials and data were collected. All materials and data were given statistical treatment and analyzed in all groups. Results The percentage of males, smoking rate, level of serum creatinine (SCr), Hcy concentration and postoperative ticagrelor intake rate were higher in HHcy group than those in non-HHcy group (P<0.05). The percentage of males, SCr level, Hcy concentration and re-hospitalization rate after followed up for 1 month were higher in H-type hypertension group than those in isolated hypertension group (P<0.05). The results of Logistic regression analysis showed that the major influencing factors of 1-month re-hospitalization rate were family history of coronary heart disease, Hcy level and preoperative blood sugar level (P<0.05). Conclusion H-type hypertension, compared with isolated hypertension, has more significant influence on prognosis in patients with acute myocardial infarction (AMI). Or in another words, HHcy complicated by hypertension has a significant influence in AMI patients.

基金项目:

云南省中青年学术和技术带头人后备人才基金(2014HB035)

参考文献:

  • 2008

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