ABO血型与急性心肌梗死及血脂的相关性研究

The relationship of ABO blood type to acute myocardial infarction and plasma lipids

目的:探讨ABO血型与急性心肌梗死(AMI)及血脂的相关性。方法:连续收集2014-01-2015-01于重庆医科大学附属第一医院经选择性冠状动脉造影明确诊断为冠心病的患者1 004例。分析ABO血型与冠心病患者AMI发病率及血脂水平之间的关系。结果:1 004例冠心病患者中,A血型组AMI发病率(45.57%)显著高于非A血型组(38.48%)(P<0.05);O血型组AMI的发病率(35.29%)风险显著低于非O血型组(43.59%)(P<0.05)。A血型组的总胆固醇(TC)水平及低密度脂蛋白胆固醇(LDL-C)水平明显高于非A血型组(均P<0.01)。O血型组的LDL-C水平明显低于非O血型组(P<0.05),2组TC水平差异无统计学意义(P>0.05)。经Logistic多元回归分析摸型进行统计学分析,在调整年龄、性别、高血压病史、糖尿病病史、吸烟史、胆固醇水平后,A血型是冠心病患者发生AMI的独立危险因素(OR=1.489,95%CI 1.028~2.155,P<0.05)。中介分析模型显示,无论以模型非A血型/A血型还是模型非O血型/O血型进行分析差异均无统计学意义。结论:A血型是冠心病患者发生AMI的独立危险因素,血脂参数TC、LDL-C、脂蛋白α未在ABO血型与冠心病患者发生AMI的相关性中起中介作用。

Objective：To explore the relationship of ABO blood type to acute myocardial infarction（AMI,includeing STEMI and NSTEMI）and plasma lipids,and to estimate the mediate effects of plasma lipids using mediation analysis model.Method：A group of 1 004 consecutive patients who diagnosed with coronary artery disease（CAD）by undergoing diagnostic or interventional coronary angiography were enrolled in this cross-sectional study.The basic characterisics of different groups were compared and the association among ABO blood group,MI and plasma lipids was explored.Result：Patients with type A blood had a greater risk of AMI than non-A blood group（P〈0.05）,while patients with type O blood had a lower risk of AMI than other blood groups（P〈0.05）.Type A blood group had higher levels of total cholesterol（TC）and low density lipoprotein cholesterol（LDL-C）compared with that of non-A blood group（all P〈0.01）.Type O blood group had lower levels of LDL-C compared with that of non-O blood group,while the levels of TC between the two group didn＇t has statistic diference（P〉0.05）.After multivariable regression analysis adjusted common cardiovascular risk factors such as age,gender,hypertension,diabetes,smoking,and levels of cholesterol;type A blood group remained significantly associated with the increased risk of AMI（OR=1.489,95%CI：1.028~2.155,P〈0.05）.However,mediation analysis showed no statistic differences neither between model non-A blood group/A blood group nor between model non-O blood group/O blood group.Conclusion：Our results suggest that type A blood group is an independent risk factor for acute myocardial infarction in CAD patients,and this association doesn＇t mediated by plasma lipids.