低蛋白血症与急性ST段抬高型心肌梗死患者冠脉病变及预后的相关性研究

发布时间：2018-05-14 11:55

本文选题：低蛋白血症 + 急性ST段抬高型心肌梗死　；参考：《重庆医科大学学报》2017年02期

【摘要】：目的:探讨低蛋白血症对急性ST段抬高型心肌梗死患者冠脉病变严重程度以及近远期预后的影响。方法:回顾分析我院2014年收治入院的所有急性ST段抬高型心肌梗死(acute ST-segment elevation myocardial infarction,STEMI)患者临床资料,根据纳入与排除标准分为低蛋白血症组(n=64)和正常蛋白组(n=203),分析2组患者的冠脉病变情况,并随访心肌梗死后1年内的死亡率及主要不良心血管事件(major adverse cardiovascular events,MACE)发生率。结果:与正常蛋白组相比,低蛋白血症组患者的年龄偏大,体质指数较低,入院时血压水平偏低,KILLIP心功能分级较高(均P0.05),冠脉三支血管病变人数比例更高(P=0.010);低蛋白血症组在心肌梗死后1年内全因死亡率及7 d内的MACE发生率明显高于正常蛋白组(P=0.004;P=0.021);2组住院期间出血事件发生率无显著差异(P=0.552);多变量Cox比例风险模型分析结果显示,校正多种混杂因素后,低蛋白血症是STEMI患者1年内全因死亡的独立危险因素(HR=2.610,95%CI=1.165~5.848,P0.05)。结论:血浆白蛋白水平与STEMI患者的冠脉病变及近远期预后密切相关,低蛋白血症是评估STEMI患者预后的独立危险因素。
[Abstract]:Objective: to investigate the effect of hypoproteinemia on the severity of coronary artery disease and prognosis in patients with acute St segment elevation myocardial infarction. Methods: the clinical data of all patients with acute St segment elevation myocardial infarction (STEMI) admitted in our hospital in 2014 were retrospectively analyzed. According to the inclusion and exclusion criteria, the patients were divided into hypoproteinemia group and normal protein group respectively. The coronary artery lesions were analyzed, and the mortality and the incidence of major adverse cardiovascular events (major adverse cardiovascular events) were followed up for one year after myocardial infarction. Results: compared with the normal protein group, the patients with hypoproteinemia were older and lower body mass index (BMI). The KILLIP cardiac function grade was higher at admission (all P0.05%, the proportion of patients with coronary artery three-vessel lesion was higher than P0.0100.The mortality rate of all causes and the incidence of MACE within 7 days after myocardial infarction in the hypoproteinemia group were significantly higher than that in the normal group in 1 year after myocardial infarction. There was no significant difference in the incidence of bleeding events between the two groups during hospitalization. The results of multivariate Cox proportional risk model analysis showed that there was no significant difference in the incidence of bleeding events in the two groups. After adjusting for various confounding factors, hypoproteinemia was an independent risk factor for all death in STEMI patients within one year. Conclusion: plasma albumin level is closely related to coronary artery lesion and short-term and long-term prognosis in patients with STEMI. Hypoproteinemia is an independent risk factor for evaluating the prognosis of STEMI patients.
【作者单位】：重庆医科大学附属第一医院心血管内科;
【基金】：国家重点基础研究发展计划资助项目(编号:2014CB542400) 国家自然科学基金面上资助项目(编号:81170112、81270210) 重庆市科委资助项目(编号:CSTC2015SHMSZX0064) 国家临床重点专科建设资助项目(编号:财社[2011]170号)
【分类号】：R542.22

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