| 胡广全,汪 麟,方 玉,王 凯,陈 然,高 峰,王晓晨.急性ST段抬高型心肌梗死患者血清Lp(a)、UA、GGT与冠状动脉病变和PCI术后主要心血管不良事件的关系研究[J].,2023,(13):2489-2493 |
| 急性ST段抬高型心肌梗死患者血清Lp(a)、UA、GGT与冠状动脉病变和PCI术后主要心血管不良事件的关系研究 |
| Relationship Study between Serum Lp(a), UA and GGT with Coronary Artery Lesions and Major Adverse Cardiovascular Events after PCI in Patients with Acute ST-Segment Elevation Myocardial Infarction |
| 投稿时间：2023-02-04 修订日期：2023-02-26 |
| DOI：10.13241/j.cnki.pmb.2023.13.017 |
| 中文关键词: 急性ST段抬高型心肌梗死 Lp(a) UA GGT 冠状动脉病变 PCI 主要心血管不良事件 |
| 英文关键词: Acute ST-segment elevation myocardial infarction Lp(a) UA GGT Coronary artery lesions PCI Major adverse cardiovascular events |
| 基金项目:安徽医科大学校临床科学基金项目（2022xkj179）；安徽省自然科学基金项目（1808085QH235） |
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| 摘要 目的：探讨急性ST段抬高型心肌梗死（STEMI）患者血清脂蛋白(a)[Lp(a)]、尿酸（UA）、γ-谷氨酰转移酶（GGT）与冠状动脉病变和经皮冠状动脉介入治疗（PCI）术后主要心血管不良事件（MACE）的关系。方法：选取2019年1月～2022年7月安徽医科大学第二附属医院心血管内科收治的100例接受PCI术治疗的急性STEMI患者为STEMI组，根据Gensini积分将其分为非重度病变组56例和重度病变组44例，PCI术后随访3个月，根据是否发生MACE分为MACE亚组和非MACE亚组，另选取同期50名冠脉造影检查排除冠心病者为对照组。收集急性STEMI患者的临床资料，并检测血清Lp(a)、UA、GGT水平。分析急性STEMI患者血清Lp(a)、UA、GGT水平与Gensini评分的相关性及PCI术后MACE的影响因素。结果：与对照组比较，STEMI组血清Lp(a)、UA、GGT水平升高（P＜0.05）。重度病变组血清Lp(a)、UA、GGT水平高于非重度病变组（P＜0.05）。Spearman相关系数分析显示，急性STEMI患者血清Lp(a)、UA、GGT水平与Gensini评分呈正相关（P＜0.05）。随访3个月，100例急性STEMI患者PCI术后MACE发生率为21.00％（21/100）。多因素Logistic回归分析显示，年龄增加、KILLIP心功能分级≥Ⅲ级和Lp(a)、UA、GGT升高为PCI术后MACE的独立危险因素，左心室射血分数（LVEF）升高为独立保护因素（P＜0.05）。结论：急性STEMI患者血清Lp(a)、UA、GGT水平升高，与冠状动脉病变严重程度和PCI术后MACE密切相关，可能成为急性STEMI患者PCI术后MACE的辅助预测指标。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between serum lipoprotein(a) [Lp(a)], uric acid (UA) and γ-glutamyl transferase (GGT) with coronary artery lesions and major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: 100 patients with acute STEMI undergoing PCI admitted to the Department of Internal Medicine-Cardiovascular of the Second Affiliated Hospital of Anhui Medical University from January 2019 to July 2022 were selected as the acute STEMI group. 56 patients were divided into the non-severe lesion group and 44 patients in the severe lesion group according to the Gensini score. The patients were followed up for 3 months after PCI and were divided into MACE subgroup and non-MACE subgroup according to whether MACE occurred. 50 patients with coronary angiography excluding coronary artery disease in the same period were also selected as the control group. Clinical data of patients with acute STEMI were collected, and serum Lp(a), UA, and GGT levels were detected. The correlation between serum Lp(a), UA, GGT levels and Gensini score in patients with acute STEMI and the influencing factors of MACE after PCI were analyzed. Results: Compared with control group, serum Lp(a), UA and GGT levels in the STEMI group were increased (P＜0.05). The Lp(a), UA and GGT levels in the severe lesion group were higher than those in the non-severe lesion group (P＜0.05). Spearman correlation coefficient analysis showed that serum Lp(a), UA, GGT levels were positively correlated with Gensini score in patients with acute STEMI(P＜0.05). 3 months after follow-up, the incidence of MACE in 100 patients with acute STEMI after PCI was 21.00%(21/100). Multivariate Logistic regression analysis showed that the increased age, KILLIP cardiac function grade≥Ⅲ, elevated Lp(a), UA and GGT were independent risk factors for MACE after PCI, and the elevated left ventricular ejection fraction (LVEF) was independent protective factor (P＜0.05). Conclusion: Elevated serum Lp(a), UA and GGT levels in patients with acute STEMI are closely correlated with the severity of coronary artery lesions and MACE after PCI, and may be the auxiliary predictors of MACE after PCI in acute STEMI patients. |
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