铁代谢水平与急性心肌梗死的相关性分析

Correlation analysis of iron metabolism level and acute myocardial infarction

目的探讨急性心肌梗死(acute myocardial infarction,AMI)患者铁代谢水平和特征,并分析其与AMI的相关性。方法选取2021年12月—2022年2月于我院心内科住院,行冠状动脉造影(coronary angiography,CAG)并经纳入和排除标准筛选后的患者。根据造影结果,结合病史、心电图和检验结果,将患者分为急性心肌梗死(AMI)组和对照组。收集一般资料并完成铁代谢指标包括血清铁(Iron)、总铁结合力(total iron-binding capacity,TIBC)、转铁蛋白饱和度(transferrin saturation,TSAT)、不饱和转铁蛋白结合力(unsaturated iron-bonding capacity,UIBC)、血清铁蛋白(serum ferritin,SF)和转铁蛋白(transferrin,TRF)的检测。比较上述指标在两组患者中的水平及差异,并进行多因素二元Logistic回归分析以明确其与AMI的相关性。结果共入组120例患者,其中AMI组48例,对照组72例。AMI组Iron和TIBC水平显著低于对照组(Iron:P=0.018;TIBC:P=0.042),SF水平显著高于对照组(P=0.031)。多因素Logistic回归分析结果提示,Iron与AMI的相关性具有统计学意义(OR=0.898,P=0.033,95%CI:0.813~0.992)。结论AMI患者存在Iron、TIBC和SF等多种铁代谢指标的紊乱。其中,Iron可能为AMI的独立保护因素。

Objective To explore the level and characteristic of iron metabolism in patients with acute myocardial infarction(AMI),and to analyze the correlation between iron metabolism parameters and AMI.Methods Patients who received coronary angiography and screened by the inclusion and exclusion criteria in Cardiovascular Department of Huashan Hospital during Dec 2021 and Feb 2022 were included.Enrolled patients were divided into AMI group and control group according to the angiogram,medical history,electrocardiogram and laboratory tests.General data including iron,total iron-binding capacity(TIBC),transferrin saturation(TSAT),unsaturated iron-bonding capacity(UIBC),serum ferritin(SF)and transferrin(TRF)levels were collected.The levels and discrepancy of the above parameters were compared,and multivariate binary Logistic regression analysis was performed in order to clarify their relationship with AMI.Results A totalof 120 patients were enrolled in this study,including 48 cases in the AMI group and 72 cases in the control group.The levels of iron and TIBC in the AMI group were lower than those in the control group(iron:P=0.018;TIBC:P=0,042),while the level of SF was higher in comparison to the control group(P=0.031).The multivariate Logistic regression analysis indicated that the correlation of iron and AMI was statistically significant(OR=0.898,P=0.033,95%CI:0.813-0.992)after adjusting for confouders.Conclusion There were several disturbances regarding to iron metabolism parameters such as iron,TIBC and SF.Among them,iron was likely to be an independent protective factor for AMI.