血浆同型半胱氨酸水平在急性心肌梗死预后评估中的应用研究

Application of Plasma Homocysteine Level Prognosis Evaluation of Acute Myocardial Infarction

目的:探讨血浆同型半胱氨酸(Hcy)水平在急性心肌梗死预后评估中的应用价值。方法:选取2017年6月-2018年6月在本院接受治疗100例急性心肌梗死患者,依据GRACE评分分为高危组(n=40)、中危组(n=30)和低危组(n=30),对比分析三组再次入院率、死亡率、Hcy及相关心功能指标水平。结果:高危组随访3个月再次入院率、死亡率均明显高于中危组与低危组(P<0.05)。治疗3个月后,左室舒张末期内径变化率(ΔLVEDD)、左室射血分数(LVEF)与左室舒张末期内径(LVEDD)均低于中危组与低危组(P<0.05);高危组Hcy、心衰定量标志物(BNP)水平、肌红蛋白(Myo)和心肌肌钙蛋白I(cTnI)均明显高于中危组和低危组(P<0.05)。结论:血浆Hcy水平是一种判断急性心肌梗死预后情况的主要参考指标,能够为患者疾病治疗和预后判断提供参考。

Objective:To investigate the value of plasma homocysteine(Hcy)level in prognosis evaluation of acute myocardial infarction.Method:A total of 100 patients with acute myocardial infarction treated in our hospital from June 2017 to June 2018 were selected and divided into high-risk group(n=40),mediumrisk group(n=30)and low-risk group(n=30)according to GRACE score.The readmission rate,mortality rate,Hcy and related cardiac function indexes of the three groups were compared and analyzed.Result:Followed up for 3 months,the readmission rate and mortality rate of the high-risk group were significantly higher than those of medium-risk group and low-risk group(P<0.05).After 3 months of treatment,the rate of left ventricular diastolic diameter change,left ventricular ejection fraction and left ventricular diastolic diameter were lower than those of the medium-risk group and low-risk group(P<0.05).Hcy,quantitative marker of heart failure(BNP),myoglobin(Myo)and cardiac troponin I(cTnI)in high-risk group were significantly higher than those in the medium-risk group and low-risk group(P<0.05).Conclusion:Hcy level is a major indicator to determine the prognosis of acute myocardial infarction,which can provide a reference for the treatment and prognosis of patients.