急性感染诱发急性心肌梗死的临床特点及炎症指标相关分析

The correlation analysis of clinical characteristics and inflammation indexes of acute myocardial infarction induced by acute infection

目的:分析急性感染诱发急性心肌梗死(AMI)的临床特点及血清学指标中炎症相关指标的差异。方法:选择2019年1月—2020年6月于江苏省苏北人民医院有明确感染症状或检查证据的AMI患者79例,设为感染AMI组;将明确无感染证据的AMI患者80例,设为非感染AMI组;将有明确感染证据而未发生AMI的患者80例,设为感染无AMI组;将本院其他原因住院的排除冠心病、感染等相关疾病的患者80例,设为对照组。对4组临床资料及中性粒细胞与淋巴细胞比值(NLR)、平均血小板体积(MPV)、血清胱抑素C(Cys-C)、血浆D-二聚体/纤维蛋白原比值(D/F比值)进行研究。结果:感染AMI组与非感染AMI组之间在年龄、性别、发病到入院时间、住院时间、是否为STEMI、主要不良事件、入院时心率、左室射血分数、空腹血糖、入院脑钠肽、C反应蛋白之间差异有统计学意义(P<0.05),感染AMI组与感染无AMI组之间在年龄、性别、糖尿病、高血压病、高脂血症、慢性肾脏病之间差异存在统计学意义(P<0.05)。感染AMI组患者的NLR、Cys-C、D/F比值比非感染AMI组患者更高(P<0.05)。感染AMI组中,MPV、Cys-C比感染无AMI组更高(P<0.05),而NLR、D/F比值之间差异无统计学意义。结论:感染AMI组在主要心脏不良事件发生率、住院天数及炎症相关指标上更高,急性感染诱发AMI与感染无AMI患者的MPV、Cys-C存在差异。

Objective: To investigate the clinical characteristics of acute myocardial infarction induced by acute infection. Methods: The 79 patients with acute myocardial infarction were selected as the infection group. The 80 patients with acute myocardial infarction without evidence of infection were selected to the non-infected group. The 80 patients with clear evidence of infection but no AMI were set as the infected non-AMI group. The 80 patients without coronary heart disease, infection and other related diseases were set as the control group. The four groups were detected neutrophil to lymphocyte ratio(NLR), mean platelet volume(MPV), serum cystatin C(Cys-C) plasma D-dimer/fibrinogen ratio(D/F ratio). Results: There were differences in age, gender, time from onset to admission, length of stay, whether it was STEMI, major adverse events, heart rate at admission, LVEF, fasting blood glucose, admission BNP, and CRP between the infected AMI group and the non-infected AMI group(P<0.05). There were significant differences in age, gender, diabetes, hypertension, hyperlipidemia, and chronic kidney disease between the infected AMI group and the infected non-AMI group(P<0.05). The NLR, Cys-C and D/F ratios of patients in the infected AMI group were higher than those in the non-infected AMI group(P<0.05). In the infected AMI group, MPV and Cys-C were higher than those in the non-AMI group(P<0.05). Conclusion: Acute myocardial infarction induced by acute infection has higher MACE incidence, hospitalization days, and inflammation-related indicators than non-infected AMI.