脂联素对行急诊PCI的急性心肌梗死患者预后的预测价值

Predictive value of adiponectin to prognosis in patients with acute myocardial infarction after emergency percutaneous coronary intervention

目的探讨脂联素对行急诊经皮冠状动脉介入术(PCI)的急性心肌梗死患者预后的预测价值。方法连续入选2010年7月至2011年8月在首都医科大学附属北京友谊医院心血管中心住院治疗的首次急性心肌梗死患者共206例。根据脂联素水平分为低脂联素组与高脂联素两组,计算左室舒张末期内径、射血分数;并行冠状动脉造影,评价冠状动脉病变严重程度及冠状动脉血流情况;平均随访6个月,观察死亡率及主要不良心血管事件(MACE)发生率。结果低脂联素组在入院即刻血糖及空腹血糖水平明显高于高脂联素组(P<0.05)。高脂联素组校正的TIMI帧数(Corrected TIMI Frame Count,CTFC)明显小于低脂联素组,有统计学差异(P<0.05);两组患者住院期间死亡率无明显差异(P>0.05),低脂联素组MACE发生率高于高脂联素组(P<0.05)。结论脂联素对急性心肌梗死行急诊PCI患者的住院期间及随访期间预后有预测价值。

Objective To discuss the predictive value of adiponectin to prognosis in patients with acute myocardial infarction （AMI） after emergency percutaneous coronary intervention （PCI）. Methods The patients （n=206） with the first time AMI were chosen from July 2010 to Aug. 2011, and divided, according to level of adiponectin, into high adiponectin group and low adiponectin group. The left ventricular end-diastolic inner diameter （LVEDd） and left ventricular ejection fraction （LVEF） were calculated. The severity of coronary artery lesion and coronary flow were reviewed after coronary angiography （CAG）. All patients were followed up averagely for 6 m for observing mortality and incidence of major adverse cardiovascular events （MACE）. Results ① The levels of hospitalized immediate plasma glucose and fasting plasma glucose were significantly higher in low adiponectin group than those in high adiponectin group （P〈0.05）. The corrected TIMI frame count was significantly lower in high adiponectin group than that in low adiponectin group （P〈0.05）. ②The hospitalized mortality had no significant difference between 2 group （P〉0.05）, and incidence of MACE was higher in low adiponectin group than that in high adiponectin group （P〈0.05）. Conclusion Adiponectin has the predictive value to prognosis in patients with AMI after emergency PCI during hospitalization and follow-up period.