| 杨彩琴,马淑媗,陈颖,等.ST段抬高型心肌梗死病人血清淀粉样蛋白 A和一氧化氮水平与预后的关系[J].安徽医药,2021,25(4):809-813. |
| ST段抬高型心肌梗死病人血清淀粉样蛋白 A和一氧化氮水平与预后的关系 |
| Relationships between serum amyloid A and nitric oxide levels and prognosis in patients with ST-segment elevation myocardial infarction |
| |
| DOI：10.3969/j.issn.1009-6469.2021.04.043 |
| 中文关键词: ST段抬高型心肌梗死 血清淀粉样蛋白 A 一氧化氮 冠脉病变程度 不良预后 |
| 英文关键词: ST-segment elevation myocardial infarction Serum amyloid A Nitric oxide Degree of coronary artery disease Adverse prognosis |
| 基金项目: |
|
| 摘要点击次数: 1591 |
| 全文下载次数: 355 |
| 中文摘要: |
| 目的通过测定 ST段抬高型心肌梗死病人血清淀粉样蛋白 A(SAA)、一氧化氮(NO)水平，探讨其与病人近期预后的关系。方法选取 2016年 6月至 2018年 9月青海省心脑血管病专科医院冠心病科病房住院的 ST段抬高型心肌梗死病人 134例，均行 PCI治疗，根据冠脉狭窄程度积分(Gensini积分)分为轻度组 59例与重度组 75例，另选取同期体检健康者 81例作为对照组，检测研究对象血清 SAA、NO水平，分析 ST段抬高型心肌梗死病人血清 SAA、NO水平与 Gensini积分相关性。根据随访结果将病人分为预后良好组与预后不良组，采用 COX法分析影响病人预后不良的危险因素，应用受试者工作特征曲线(ROC)分析血清 SAA、 NO水平对病人近期预后的评估价值。结果对照组、轻度组、重度组血清 SAA水平分别是(5.16±1.03)mg/L、(34.12±6.82)mg/L、(65.15±13.03)mg/L，血清 NO水平分别为(72.17±14.43)μmol/L、(64.32±12.86)μmol/L、(55.27±11.05)μmol/L，轻度组与重度组 Gensini积分分别为(45.26±9.05)分、(128.79±25.79)分，与对照组相比，轻度组、重度组血清 SAA水平升高(P<0.05)血清 NO水平降低(P<0.05)；与轻度组相比，重度组血清 SAA水平、 Gensini积分升高(P<0.05)，血清 NO水平降低(P<0.05)； ST高型心肌梗死病人血清 SAA水平与 Gensini积分正相关(r=0.763，P<0.05)，血清 NO水平与 Gensini积分负相关(r=?0.807，P<0.05)；预后良好组、预后不良组血清 SAA水平分别为(35.79±7.16)mg/L(63.94±12.78)mg/L，血清 NO水平分别为(66.17±13.23)μmol/L(37.06± 段抬，8.01)μmol/L与预后良好组相比，预后不良组血清 SAA水平升高(P<0.05)，血清 NO水平下降(P<0.05)； COX分析显示血清 SAA、 NO水平是影响 ST段抬高型心肌梗死病人预后的独立危险因素(HR= 2.099，2.355，P<0.05)； ROC曲线显示，血清 SAA、NO水平及二者联合检测预测 ST段抬高型心肌梗死病人治疗 3个月不良预后的曲线下面积为 0.846(灵敏度为 79.5%，特异度为 82.3%)， |
| 英文摘要: |
| Objective To investigate the relationship between serum amyloid A (SAA) and nitric oxide (NO) levels and short-term prognosis in patients with ST-segment elevation myocardial infarction by detection of them.Methods A total of 134 patients with STsegment elevation myocardial infarction hospitalized in coronary artery disease care unit (CCU) of Qinghai Cardiovascular and Cerebrovascular Disease Hospital from June 2016 to September 2018 were treated with PCI. According to Gensini score, 59 patients with mildcoronary artery disease and 75 patients with coronary artery disease were assigned into two respective groups. Another 81 healthy persons were selected as control group during the same period. Serum SAA and NO levels were measured, and the correlations between serum SAA and NO levels and Gensini score in patients with ST-segment elevation myocardial infarction were analyzed. According to the follow-up results, patients were assigned into good prognosis group and poor prognosis group. COX method was used to analyze the riskfactors affecting the poor prognosis of patients, and receiver operating characteristic curve (ROC) was used to analyze the values of serum SAA and NO levels in evaluating the short-term prognosis of patients.Results The levels of SAA in control group, mild group andsevere group were (5.16±1.03) mg/L, (34.12±6.82) mg/L and (65.15±13.03) mg/L respectively. The levels of NO in control group, mildgroup and severe group were (72.17±14.43) μmol/L, (64.32±12.86) μmol /L and (55.27±11.05) μ mol/L respectively. The Gensiniscores in mild group and severe group were (45.26±9.05) and (128.79±25.79). Compared with control group, the serum SAA levels inmild group and severe group increased (P<0.05), while the serum NO level decreased (P< 0.05). Compared with mild group, serum SAA level and Gensini score increased (P<0.05) and serum NO level decreased (P<0.05) in severe group. Serum SAA level was positively correlated with Gensini score in ST-segment elevation myocardial infarction (r=0.763, P<0.05), while serum NO level was negatively correlated with Gensini score (r=?0.807, P<0.05). The level of serum SAA was (35.79±7.16) mg/L in good prognosis group and(63.94±12.78) mg/L in poor prognosis group. The level of serum NO was (66.17±13.23) μmol/L in good prognosis group and (37.06±8.01) μmol/L in poor prognosis group. Compared with the good prognosis group, the serum SAA level in the poor prognosis group increased (P<0.05), while the serum NO level decreased (P<0.05). COX analysis showed that serum SAA and NO levels were independent risk factors affecting the prognosis of ST-segment elevation myocardial infarction (HR=2.099, 2.355, P<0.05). The ROC curveshowed that the areas under the curve of serum SAA and NO levels and their combined detection for predicting adverse prognosis of ST-segment elevation myocardial infarction after 3 months of treatment were 0.846 (sensitivity was 79.5%, specificity was 82.3%), 0.715(sensitivity was 59%, specificity was 83.6%) and 0.907 (sensitivity was 87.2%, specificity was 83.6%).Conclusion Serum SAA level increases and NO level decreases in patients with ST-segment elevation myocardial infarction, which are closely related to the severityof coronary artery lesions, and may be used as biological indicators to predict the poor prognosis of patients after PCI. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
