尿微量白蛋白与老年急性ST段抬高心肌梗死患者急诊介入治疗预后分析

Predictive value of microalbuminuria for prognosis of the elderly patients with STEMI treated with primary PCI

目的探讨尿微量白蛋白(MAU)对直接PCI的老年ST段抬高心肌梗死(STEMI)患者预后的预测价值。方法选择老年STEMI患者101例,根据MAU水平分为MAU阳性组(MAU>20 mg/24 h.54例)和MAU阴性组(MAU≤20 mg/24 h,47例)。观察发病30天及1年的主要不良心血管事件(MACE)发生率。结果 MAU阳性组发病30天及1年发生MACE分别为15例(27.8%)和25例(46.3%);MAU阴性组发病30天未发生MACE,随访1年发生MACE 3 例(6.4%),两组比较差异显著(P<0.01)。MAU阳性组多支血管病变明显高于MAU阴性组(87.0% vs 53.2%,P<0.01)。结论 MAU是预测老年STEMI患者30天及1年发生MACE的危险因素。

Objective To evaluate the predictive value of the microalbuminuria（MAU） for prognosis of the elderly patients with ST segment elevation myocardial infarction（STEMI） treated with primary PCI. Methods 101 elderly STEMI patients treated with primary PCI were enrolled and urinary albumin excretion rate was measured with immunoturbidimetry in the first 48 hours after admission. MAU〉20 mg/24 h was MAU positive group and MAU≤20 mg/24 h was MAU negative group. The correlation between MAU and the incidence of the main adverse cardiac event （MACE） in 30 days and one year was assessed in the patients. Results The incidences of 30 d and one-year MACE were significantly higher in MAU positive group（27.8% and 46.3%） than in MAU negative group（0 and 6.4%, P 〈 0.01）. The coronary artery lesion was more extensive in MAU positive group than in MAU negative group（87.0% vs 53.2%, P 〈0.01）. Conclusion MAU probably is a risk factor for predicting MACE within 30 days and one year in the elderly STEMI patients treated with primary PCI.