ApoA1与急性心肌梗死患者左心室收缩功能的关系

Serum ApoA1 levels and left ventricular systolic function in patients with acute myocardial infarction

目的:分析研究血清载脂蛋白A1(Apolipoprotein A1,ApoA1)与急性心肌梗死患者(acute myocardial infarction,AMI)左心室射血分数(left ventricular ejection fraction,LVEF)的关系。方法:纳入2017年7月至2018年4月于西安交通大学第一附属医院心内科确诊急性心肌梗死并行冠状动脉造影的834例患者,按照血清ApoA1水平分为低、中、高3组,比较各组间基线资料及临床生化指标的差异,logistics回归分析血清ApoA1与患者LVEF的关系。结果:高ApoA1组较低ApoA1组患者左心室舒张末内径(left ventricular end diastolic diameter,LVEDd)更小[(49.45±15.00)mm vs(45.37±15.15)mm,P=0.012],LVEF更高(51.94%±7.07%vs 56.24%±8.51%,P<0.01);Spearman相关分析提示血清ApoA1与LVEF之间呈显著正相关(r=0.131,P=0.004);logistics回归分析显示调整所有基线差异后,ApoA1仍与左心室重度收缩功能不全(LVEF<40%)呈显著负相关(P<0.001);结论:血清ApoA1与急性心肌梗死患者LVEF呈显著正相关,是急性心肌梗死患者左心室收缩功能不全的保护性预测因子。

Objective:To explore the relationship between ApoA1 and left ventricular ejection fraction(LVEF)of acute myocardial infarction(AMI)patients.Methods:From July 2017 to April 2018,834 patients who were diagnosed with acute myocardial infarction were recruited in this study and were divided into three groups according to the concentration of serum ApoA1,which included the L-ApoA1 group,the M-ApoA1 group and the H-ApoA1 group.Baseline data and clinical biochemical indicators among groups were compared.Logistics analysis was used to investigate the relationship of ApoA1 and LVEF of AMI patients.Results:The left ventricular end-diastolic diameter(LVEDd)of AMI patients was decreased in H-ApoA1 than that in L-ApoA1 group[(49.45±15.00)mm vs(45.37±15.15)mm,P=0.012].Meanwhile,the LVEF in H-ApoA1 group was obviously improved compared to the L-ApoA1 group(51.94%±7.07%vs 56.24%±8.51%,P<0.01).Spearman analysis showed that serum ApoA1 was positively related with LVEF(r=0.131,P=0.004).Logistics regression analysis showed that ApoA1 was significantly negatively correlated with severe left ventricular systolic insufficiency(LVEF<40%,P<0.001)after adjusting for all baseline factors.Conclusion:ApoA1is remarkably positively correlated with LVEF in patients with acute myocardial infarction,and it is a protective factor of left ventricular systolic dysfunction in AMI patients.