重庆医学2017，Vol.46Issue(31)：4342-4344,4347,4.DOI:10.3969/j.issn.1671-8348.2017.31.007
血浆同型半胱氨酸与急性心肌梗死患者预后的相关性研究
Study on correlation between plasma homocysteine level and prognosis in patients with acute myocardial infarction
摘要
Abstract
Objective To investigate the correlation between plasma homocysteine(Hcy) and long term occurrence of main adverse cardiac events(MACE) in the patients with acute myocardial infarction(AMI).Methods A total of 326 inpatients with AMI in the cardiology department of this hospital from Mar.2012 to Dec.2014 were continuously included.The related laboratory biochemical indicators such as Hcy were detected according to the standard flow process by the hospital clinical laboratory department.The Hcy level and MACE occurrence rate were performed the receiver operating characteristic(ROC) curve analysis.The research subjects were divided into the Hcy(L) group and Hcy(H) group according to the cut-off value 11.69μmol/L.The base line data of all subjects were collected and the follow up was conducted for recording MACE.Results The plasma N-terminal pro-brain natriuretic peptide (NT-ProBNP) level in the Hcy(L) group was significantly lower than that in the Hcy(H) group[-(501.46-±-118.35)pg/mL vs.(1 324.11 ± 523.13) pg/mL,P =0.02],while the left ventricular ejection fraction(LVEF) was significantly higher than that in the Hcy(H) group[(55.23 ± 9.48) ％ vs.(50.79 ± 10.68) ％,P =0.03].After 1-year follow up,LVEF in the Hcy(H) group was significantly decreased compared with the base line [(45.32±10.18)％ vs.(50.79±10.68)％,P＜0.05],moreover the MACE occurrence risk in the Hcy(H) group was significantly higher than that in the Hcy(L) group,the difference after correcting the related confounding factors had statistical significance (P=0.048),but LVEF and minor axis shortening rate of left ventricle(FS) in the Hcy(L) group had no obvious difference compared with the base line data[(54.43 ± 10.68)％ vs.(55.23± 9.48) ％,(28.56±6.21) ％ vs.(29.22±5.30) ％,P＞0.05].Conclusion The risk of long term MACE occurrence in the patients with AMI complicating plasma high Hcy level is obviously increased compared with that in the patients with plasma low Hcy level and the prognosis is poor,prompting that plasma high Hcy level is one of possible independent predicting factors for poor prognosis in the patients with AML But its action mechanism and whether the Hcy interventional therapy improving prognosis of AMI patients still need to further study.关键词
同型半胱氨酸/急性心肌梗死/主要心血管不良事件Key words
homocysteine/acute myocardial infarction/MACE分类
医药卫生引用本文复制引用
薛焱,刘海润,杨子聪,曾涛,刘伶,许能文,施莹..血浆同型半胱氨酸与急性心肌梗死患者预后的相关性研究[J].重庆医学,2017,46(31):4342-4344,4347,4.基金项目
广西壮族自治区卫生厅自筹经费科研课题(Z2014213) （Z2014213）
广西壮族自治区重大科技攻关课题(桂科攻14124003-9). （桂科攻14124003-9）
