急性心肌梗死患者醛固酮水平与冠状动脉病变程度和早期预后的关系研究

Relationship among aldosterone level,severity of coronary artery lesion and early prognosis in patients with acute myocardial infarction

目的探讨急性心肌梗死(AMI)患者醛固酮水平与冠状动脉(冠脉)病变严重程度和早期预后的关系。方法选取2015年1月至2017年1月于石家庄市第二医院心内科诊断为急性ST段抬高型心肌梗死并行急诊经皮冠状动脉介入术(PCI)的80例患者为研究对象,依据入院后醛固酮水平分为醛固酮正常组(n=52)和醛固酮增高组(n=28),比较两组间冠脉病变程度;随访3个月后,对比两组心血管事件发生情况,并通过彩色多普勒超声评价心脏左室舒张末径(LVDD)及左室射血分数(LVEF)。结果入院时,醛固酮增高组冠脉病变积分明显高于醛固酮正常组,差异有统计学意义(P<0.05)。随访3个月后,两组中均无患者发生再梗死、心源性死亡及休克;醛固酮增高组心律失常、心衰的发生率高于醛固酮正常组,差异均有统计学意义(P均<0.05);醛固酮增高组LVDD大于醛固酮正常组,差异有统计学意义(P<0.05),两组间的LVEF相比,差异无统计学意义(P>0.05)。结论醛固酮水平高的AMI患者,其冠脉病变程度较重,左室重构出现较早,提示早期不良预后。

Relationship among aldosterone level,severity of coronary artery lesion and early prognosis in patients with acute myocardial infarction[Abstract]Objective To investigate the relationship among level of aldosterone(ALD),severity of coronary artery lesion and early prognosis in patients with acute myocardial infarction(AMI).Methods The patients with acute ST-segment elevation myocardial infarction(STEMI)under gone emergency PCI(n=80)were chosen from Department of Cardiology in the Second Hospital of Shijiazhuang City from Jan.2015 to Jan.2017,and divided,according to ALD level after hospitalization,into normal ALD group(n=52)and high ALD group(n=28).The severity of coronary artery lesion was compared between 2 groups.After followed up for 3 months,the prevalence of major adverse cardiovascular events(MACE)was compared,and left ventricular end-diastolic inner diameter(LVEDd)and left ventricular ejection fraction(LVEF)were reviewed by using color Doppler ultrasonography.Results The integral of coronary artery lesion was significantly higher in high ALD group than that in normal ALD group(P<0.05).There were no patients offered from re-infarction,cardiac death and shock after followed up for 3 months.The incidence of arrhythmia and heart failure was higher in high ALD group than that in normal ALD group(all P<0.05).LVEDd was higher in high ALD group than that in normal ALD group(P<0.05),and difference in LVEF had no statistical significance between 2 groups(P >0.05).Conclusion The severity of coronary artery lesion is higher and left ventricular remodeling occurs earlier in AMI patients with higher ALD level,which indicates poor early prognosis.