并发恶性心律失常的急性心肌梗死患者血清25-羟维生素D3、中性粒细胞/淋巴细胞比值及心肌酶学指标的变化

Significance of serum 25-(OH)D3,NLR and myocardial enzyme indexes in patients with AMI complicated with malignant arrhythmia

目的探讨并发恶性心律失常的急性心肌梗死(AMI)患者血清25-羟维生素D3[25-(OH)D3]、中性粒细胞/淋巴细胞比值(NLR)及心肌酶学指标的变化特点。方法选取230例AMI患者,入院后72 h内接受标准12导联心电图、心电监护监测。根据监测结果是否出现恶性心律失常分为恶性组39例、非恶性组191例,对比两组入院24 h内的血清25-(OH)D3、NLR、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、超敏C反应蛋白(hs-CRP)、左室射血分数(LVEF)、左室短轴缩短率(FS)。结果恶性组患者的血清25-(OH) D3水平低于非恶性组(P <0.05),恶性组的NLR、CK-MB、cTnI水平高于非恶性组(P <0. 05);恶性组患者的LVEF、FS低于非恶性组(P <0.05),恶性组的血清hs-CRP水平高于非恶性组(P <0. 05); logistic回归分析结果显示:血清25-(OH)D3降低,NLR、CK-MB、cTnI水平升高是AMI患者并发恶性心律失常的独立危险因素(P<0.05)。结论并发恶性心律失常的AMI患者血清25-(OH)D3水平降低,NLR、CK-MB、cTnI水平升高,血清25-(OH)D3降低,NLR、CK-MB、cTnI水平升高是AMI患者并发恶性心律失常的独立危险因素。

Objective To explore the characteristics of serum 25-hydroxyvitamin D3[25-(OH)D3],neutrophils / lymphocyte ratio (NLR) and myocardial enzyme indexes in acute myocardial infarction (AMI) patients complicated with malignant arrhythmia. Methods Two hundred and thirty patients with AMI were selected.The patients received standard 12 lead electrocardiogram and ECG monitoring monitoring after admission.All patients were divided into malignant arrhythmia group(39 cases) and non malignant group (191 cases) according to the results of malignant arrhythmia.The serum 25-(OH)D3,NLR,creatine kinase,Isoenzyme (CK-MB),troponin I(cTnI),hypersensitive C reactive protein (hs-CRP),left ventricular ejection fraction (LVEF) and left ventricular short axis shortening rate (FS) of the two groups were compared in 24 h after admission. Results The serum 25-(OH)D3 of malignant arrhythmia group was lower than that in the non malignant arrhythmia group(P<0.05),and the NLR,CK-MB and cTnI of malignant arrhythmia group were higher than those in the non malignant arrhythmia group(P<0.05).The LVEF and FS of the malignant arrhythmia group were lower than those in the non malignant arrhythmia group(P<0.05).The serum hs-CRP of the malignant arrhythmia group was higher than that in the non malignant arrhythmia group.logistic regression analysis showed that the independent risk factor of AMI patients complicated with malignant arrhythmia are serum 25-(OH)D3 decreased,elevated levels of NLR,CK-MB and cTnI (P<0.05). Conclusion Decreased serum 25-(OH)D3 and incresed NLR ck-mb cTnI level are independent risk factors for AMI patients complicated with malignant arrhythmia.