摘要
目的探讨心血管危险因素及炎性因子对不同部位急性ST段抬高型心肌梗死预后的影响。方法收集2018年1月至2021年8月福建医科大学附属泉州第一医院心血管内科收治的不同部位急性ST段抬高型心肌梗死患者共287例,分为下列四组:急性前壁梗死组(n=132)、急性下壁梗死组(n=86)、急性正后壁梗死组(n=37)和急性右心室梗死组(n=32)。分别比较四组患者的心血管危险因素、炎性因子水平、冠状动脉造影结果及严重临床表现。结果急性前壁梗死组的高血压病史占比72.0%,糖尿病病史占比51.5%,低密度脂蛋白胆固醇(LDL-C)为5.03(4.44,5.86)mmol/L,吸烟史占比97.0%,均高于其他三组,差异有统计学意义(P<0.05);急性前壁梗死组的血清超敏C反应蛋白(hs-CRP)[15.03(13.04,16.34)mg/ml],白细胞介素-6(IL-6)[284.31(260.92,300.41)pg/ml],白细胞介素-8(IL-8)[912.33(818.03,930.28)pg/ml]及基质金属蛋白酶-9(MMP-9)[85.81 (75.56,95.21)ng/ml]均高于其他三组,差异有统计学意义(P<0.05);急性前壁梗死组的冠状动脉2支病变比例35.6%,弥漫性病变比例62.1%,重度狭窄比例68.2%,均高于其他三组,差异有统计学意义(P<0.05);急性前壁梗死组出现心力衰竭的比例为40.9%,出现心源性休克的比例为16.7%,出现室性心律失常的比例为55.3%,出现心源性死亡的比例为11.4%,均高于其他三组,差异有统计学意义(P<0.05)。结论急性前壁梗死患者主要的心血管危险因素所占比例高,血清hs-CRP、IL-6、IL-8及MMP-9等炎性因子水平升高也最明显,冠状动脉病变最严重且预后差。
Objective To investigate the effects of cardiovascular risk factors and inflammatory factors on the prognosis of acute ST-segment elevation myocardial infarction at different sites.Methods From January 2018 to August 2021,a total of 287 patients with acute ST-segment elevation myocardial infarction in different parts admitted to the Department of Cardiovascular Medicine,Quanzhou First Hospital Affiliated to Fujian Medical University were collected and divided into four groups:acute anterior wall infarction group(n=132),acute inferior wall infarction group(n=86),acute median posterior wall infarction group(n=37)and acute right ventricular infarction group(n=32).The cardiovascular risk factors,inflammatory factor levels,coronary angiographic findings and severe clinical manifestations were compared among the four groups,respectively.Results In the acute anterior wall infarction group,the history of hypertension accounted for 72.0%;the history of diabetes accounted for 51.5%;the level of low-density lipoprotein cholesterol(LDL-C)was 5.03(4.44,5.86)mmol/L;and the smoking history accounted for 97.0%;all of which were higher than in the other three groups,and the differences were statistically significant(P<0.05).In the acute anterior wall infarction group,the level of highsensitivity C-reactive protein(hs-CRP)was 15.03(13.04,16.34)mg/ml;the level of interleukin-6(IL-6)was 284.31(260.92,300.41)pg/ml;the level of interleukin-8(IL-8)was 912.33(818.03,930.28)pg/ml and the level of matrix metallopeptidase-9(MMP-9)was 85.81(75.56,95.21)ng/ml;all of which were higher than in the other three groups,and the differences were statistically significant(P<0.05).In the acute anterior wall infarction group,the proportion of coronary 2-branch lesions was 35.6%;the proportion of diffuse lesions was 62.1%,and the proportion of severe stenosis was 68.2%;all of which were higher than those of the other three groups,and the differences were statistically significant(P<0.05).In the acute anterior wall infarction group,the proportion of heart failure was 40.9%;the proportion of cardiogenic shock was 16.7%;the proportion of ventricular arrhythmia was 55.3%;and the proportion of cardiogenic death was 11.4%;all of which were higher than those of the other three groups,and the differences were statistically significant(P<0.05).Conclusion Patients with acute anterior wall infarction had a high proportion of major cardiovascular risk factors and the most significant elevated levels of inflammatory factors such as hs-CRP,IL-6,IL-8 and MMP-9 in serum,and had the most severe coronary lesions with poor prognosis.
作者
邓锂峰
邓少雄
DENG Li-feng;DENG Shao-xiong(Department of Preventive Medicine,School of Health,Quanzhou Medical College,Quanzhou 362000,China;Department of Cardiovascular Medicine,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou 362000,China)
出处
《中国心血管病研究》
CAS
2022年第12期1108-1113,共6页
Chinese Journal of Cardiovascular Research
关键词
心肌梗死
危险因素
炎性因子
冠状动脉病变
Myocardial infarction
Risk factors
Inflammatory factors
Coronary artery disease
