血浆同型半胱氨酸对急性ST段抬高型心肌梗死患者血压及心血管事件的影响

Effect of Plasma Homocysteine on Blood Pressure and Cardiovascular Events in Patients with Acute ST-segment Elevation Myocardial Infarction

目的探讨血浆同型半胱氨酸(Hcy)对急性ST段抬高型心肌梗死(STEMI)患者中心动脉压(CAP)及心血管事件(MACE)的影响。方法选择2019年1月—2019年12月在烟台市莱阳中心医院接受急诊经皮冠状动脉介入治疗(PCI)的122例STEMI患者作为研究对象,根据血浆Hcy水平分为正常Hcy组(Hcy<15μmol/L,n=80)和高Hcy组(Hcy≥15μmol/L,n=42)。比较两组的临床资料;采用Kaplan-Meier法绘制患者生存曲线,比较不同因素对STEMI患者MACE的影响;采用Cox回归分析探讨STEMI患者MACE的危险因素。结果高Hcy组高血压比例、中心动脉收缩压(CASP)、肱动脉收缩压(SBP)高于正常Hcy组,差异有统计学意义(P<0.05)。Pearson相关性分析显示,血浆Hcy与CASP、SBP、DBP呈正相关,差异有统计学意义(P<0.05)。Kaplan-Meier生存曲线分析结果显示:CAPP≥51.5mmHg及PP≥52 mm Hg、吸烟及双支或多支病变患者MACE发生风险增加,差异有统计学意义(P<0.05)。多因素Cox回归分析结果显示,年龄、吸烟及PP是STEMI患者MACE发生的独立危险因素,差异有统计学意义(P<0.05)。结论血浆Hcy与STEMI患者血压水平关系密切,年龄、吸烟和PP增大是STEMI患者MACE的独立危险因素。

Objective To investigate the effect of plasma homocysteine(Hcy)on Central arterial pressure(CAP)and major adverse cardiovascular events(MACE)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 122 patients with STEMI who received emergency percutaneous coronary intervention(PCI)were divided into normal Hcy group(Hcy<15μmol/L,n=80)and high Hcy group(Hcy≥15μmol/L,n=42)according to plasma Hcy level,and the clinical data of the two groups were compared.The Kaplan-Meier method was used to plot the survival curve of patients and compare the effects of different factors on MACE in STEMI patients.Cox regression analysis was used to explore the risk factors for MACE in STEMI patients.Results The proportion of hypertension,central arterial systolic blood pressure(CASP)and brachial artery systolic blood pressure(SBP)were higher in the high Hcy group than in the normal Hcy group(P<0.05).Pearson correlation analysis showed that plasma Hcy was positively correlated with CASP,SBP and brachial artery diastolic blood pressure(DBP)(P<0.05).Kaplan-Meier survival curve analysis showed that patients with CAPP≥51.5 mm Hg,PP≥52 mm Hg,smoking and degree of lesions had an increased risk of MACE(P<0.05).Multivariate Cox regression analysis showed that smoking and PP were independent risk factors for MACE in patients with STEMI(P<0.05).Conclusion Plasma Hcy is closely related to blood pressure levels,smoking and PP are independent risk factors for MACE in STEMI patients.