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高同型半胱氨酸血症对急性ST段抬高型心肌梗死患者心功能及预后的影响 被引量:4

Effect of hyperhomocysteinemia on cardiac function and prognosis in patients with acute ST-segment elevation myocardial infarction
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摘要 目的分析血清同型半胱氨酸(Hcy)水平对急性ST段抬高型心肌梗死(STEMI)急诊行经皮冠状动脉介入(PCI)患者心功能及预后的影响。方法选取2021年1月~2022年6月上海市松江中心医院确诊的STEMI并行PCI治疗的83例患者,根据入院时血清Hcy水平分为正常组(Hcy<15μmol/L,52例)、高Hcy组(Hcy≥15μmol/L,31例)。随访患者PCI术后超声心动图心功能的变化及主要心血管不良事件发生情况,通过logistic回归分析预后影响因素。结果与Hcy正常组比较,高Hcy组左心室射血分数相对较低,术后12个月复查心脏彩超提示左室射血分数下降更明显,差异有统计学意义(P=0.000);高Hcy组患者冠状动脉三支病变比例高于Hcy正常组,差异有统计学意义(P=0.029);高Hcy组术后随访心血管不良事件发生率显著高于Hcy正常组,差异有统计学意义(P=0.029)。Logistic回归分析显示,年龄、住院期间左心室射血分数(LVEF)、血清Hcy水平是STEMI患者PCI术后发生心血管不良事件的独立风险因素(P<0.05)。结论高龄、低LVEF、高Hcy的STEMI患者发生心血管不良事件风险更高,血清Hcy水平是STEMI患者预后的独立风险因素。 Objective To analyze the effect of serum homocysteine level on cardiac function and prognosis of patients with acute ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention.Methods From January 2021 to June 2022,83 patients diagnosed with acute STEMI who underwent percutaneous coronary intervention(PCI)were enrolled.They were divided into 2 groups according to serum Hcy level as follows:the N-Hcy group(Hcy<15μmol/L,n=52)and H-Hcy group(Hcy≥15μmol/L,n=31).The changes of cardiac function after PCI were followed up by follow-up echocardiography,and the occurrence of major adverse cardiovascular events was followed up.A logistic regression model was established to analyze the influence of serum Hcy level on the prognosis of STEMI patients.Results Left ventricular ejection fraction was lower in the H-Hcy group than in the N-Hcy group,12 months after the operation suggested a more significant decrease(P=0.000);The proportion of coronary artery lesions in H-Hcy patients was higher(P=0.029);The incidence of adverse cardiovascular events was significantly higher in the H-Hcy group than in the N-Hcy group(P=0.029);Logistic regression analysis showed that age,LVEF and serum Hcy levels during hospitalization are independent risk factors for adverse cardiovascular events in STEMI patients after PCI.Conclusion The elderly,low LVEF and high Hcy patients with STEMI have a higher risk of adverse cardiovascular events.Serum Hcy level is an independent risk factor for the prognosis of STEMI patients.
作者 吴丽丽 陈玲玲 孙亚丽 吴梅梅 Wu Lili;Chen Lingling;Sun Yali(Department of Cardiology,Songjiang Central Hospital,Shanghai 200070,China)
出处 《中华保健医学杂志》 2023年第2期135-138,共4页 Chinese Journal of Health Care and Medicine
基金 上海市松江区科技攻关重点项目(20sjkjgg14)。
关键词 同型半胱氨酸 急性ST段抬高型心肌梗死 左心室射血分数 预后 Homocysteine Acute ST-segment elevation myocardial infarction Left ventricular ejection fraction Prognosis
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