摘要
目的:探讨老年急性心肌梗死(AMI)患者血同型半胱氨酸水平(HCY)与梗死后心功能不全的相关性。方法:选取128例首次确诊为AMI的患者,年龄>60岁,根据血HCY值分为H组(88例,≥15μmol/L)及C组(40例,<15μmol/L),记录两组临床情况、生化指标、Killip分级等。结果:与C组相比,H组的WBC、HCY、纤维蛋白源(Fib)要明显升高,H组的多支血管病变比例及心力衰竭的发生率均明显高于C组(P<0.05)。Spearman相关分析提示HCY水平与WBC、Fib、吸烟呈正相关(r=0.76,0.36,0.19;P=0.00,0.00,0.03)。二元Logistic分析提示高HCY是强的梗死后心力衰竭发生的预测因子(OR:1.34,95%CI:1.17~1.53)。结论:HCY水平的升高与老年AMI心功能不全的发生独立相关。因此,HCY水平升高对老年梗死后心功能不全的发生有预测价值,机制可能与诱发炎症反应及促进血栓形成有关。
Objective: To investigate the relationship between serum homocysteine( HCY) levels and post infarction cardiac dysfunction in elderly patients with acute myocardial infarction( AMI). Methods: 128 patients over 60 years old who first presented with AMI in General Hospital of China Aviation from January 2011 to January 2015 were enrolled. They were divided into two groups according to the fasting plasma HCY levels:group H( 88 patients,≥15 μmol/L) and group C( 40 patients, 15 μmol/L). Clinical characteristics、biochemical indexand Killip classification were recorded. Results: Leucocyte,fibrinogen and HCY levels were significantly higher in group H according to group C. The proportion of multivessel disease and the incidence of heart failure in group H were also higher( P 〈0. 05). Spearman correlation analysis showed that the HCY level and leucocyte,fibrinogen,smoking was positively correlated( r = 0. 76,0. 36,0. 19; P = 0. 00,0. 00,0. 03).Logistic analysis suggested that high HCY was a strong predictor of post infarction heart failure,with an Odd ratio of 1. 34( 95% CI: 1. 17-1. 53,P = 0. 00). Conclusion: Elevated HCY level was independently associated with increased risk ofheartdysfunction in elderly patients after AMI. Thus,hyper-homocysteine may remain a useful prognostic marker for the cardiac function. The mechanisms may be inducing inflammatory reaction and promoting thrombosis.
出处
《心肺血管病杂志》
2018年第2期95-97,121,共4页
Journal of Cardiovascular and Pulmonary Diseases