急性心肌梗死患者丁酰胆碱酯酶活性与炎症因子、预后的关系分析

Relationship between the activity of butyrylcholinesterase and inflammatory factors,prognosis in patients with acute myocardial infarction

目的探究急性心肌梗死患者丁酰胆碱酯酶(butyrylcholinesterase,BChE)活性与炎症因子、预后的关系。方法选择83例急性心肌梗死患者作为研究对象,按照血清中BChE活性高低分为低BChE活性组及高BChE活性组。对患者心功能进行评级,测定左心室射血分数(left ventricular ejection fraction,LVEF),测定患者血清高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)、白细胞介素6(interleukin-6,IL-6)及肿瘤坏死因子α(tumor necrosis factor-α,TNF-α),观察患者预后。结果两组患者心功能评级差异无统计学意义(P>0.05);低BChE活性组患者LVEF值低于高BChE活性组(P<0.05);低BChE活性组患者hs-CRP、IL-6、TNF-α水平高于高BChE活性组患者(P<0.05);BChE活性与LVEF呈显著性正相关(r=0.356,P<0.05),与hs-CRP、IL-6、TNF-α呈显著性负相关(r=-0.348、-0.316、-0.333,P均<0.05);Logistic多因素分析显示,BChE活性是心肌梗死患者预后的独立影响因素。结论BChE活性可作为心肌梗死患者心脏功能、预后的预测指标之一,其机制可能是通过影响心肌梗死后炎症因子水平预测预后。

Objective To explore the relationship between the activity of butyrylcholinesterase(BChE)and inflammatory factors and prognosisin in patients with acute myocardial infarction(AMI).Methods Eighty-three inpatients with AMI treated in the hospital were selected as the subjects.According to the different activity of BChE in serum,they were divided into low-activity BChE group and high-activity BChE group.The cardiac function was graded and left ventricular function(LVEF),serum high sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis factorα(TNF-α)were determined.The prognosis was collected.Results There was no significant difference in the grade of cardiac function between two groups(P>0.05),but the LVEF of low-activity BChE group was smaller than that of high-activity BChE group(P<0.05).The levels of hs-CRP,IL-6 and TNF-αwere significantly higher in low-activity BChE group than in high-activity BChE group(P<0.05).The activity of BChE was positively correlated with LVEF(r=0.356,P<0.05),and negatively correlated with hs-CRP,IL-6 and TNF-α(r=-0.348,-0.316,-0.333,P<0.05).Logistic multivariate analysis of the prognosis of the patients showed that BChE activity was an independent factor affecting the prognosis of patients with myocardial infarction.Conclusion The activity of BChE can be used as a predictor of cardiac function in patients with myocardial infarction.The mechanism may be predicting the prognosis by reflecting the inflammatory level after myocardial infarction.