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  • 周紫薇,齐 迪,SIN Sathya,等.鸢尾素与急性心肌梗死患者短期预后相关性分析[J].同济大学学报(医学版),2019,40(6):865-871.    [点击复制]
  • ZHOU Zi-wei,QI Di,SIN Sathya,et al.Association between serum irisin levels and short-term prognosis in patients with acute myocardial infarction[J].同济大学学报(医学版),2019,40(6):865-871.   [点击复制]
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鸢尾素与急性心肌梗死患者短期预后相关性分析
周紫薇,齐迪,SINSathya,周秋莲,许嘉鸿
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(同济大学附属同济医院心血管内科,上海 200065;华中科技大学同济医学院,武汉 43003;上海大学生命科学学院,上海 200444)
摘要:
目的 探讨血清鸢尾素(Irisin)水平与急性心肌梗死(acute myocardial infarction, AMI)患者行经皮冠状动脉介入治疗(percutaneous coronary intervention, PCI)术后短期内发生主要心血管不良事件(major adverse cardiac event, MACE)的相关性分析。方法 2018年05月至2018年12月在同济大学附属同济医院首次被诊断为急性ST段抬高型心肌梗死并行PCI的75例患者作为实验组,36例不稳定型心绞痛患者为UAP组,35例在我院行冠脉造影正常者为健康组;UAP组和健康组作为对照组。所有的受试者均进行病史采集、体格检查、血生化指标检测,并采用ELISA法检测血清Irisin水平。实验组患者术后随访6个月,记录所发生的MACE事件,按照有无心血管事件分为事件组和非事件组,并进行统计学分析。结果 急性心肌梗死组中血清鸢尾素水平显著低于对照组[(854.960±508.609) ng/mL vs (1253.363±1059.100) ng/mL]差异有统计学意义(P<0.05),其中AMI再次入院组的血清鸢尾素水平明显低于AMI未发生再入院组[(637.3404±320.4924) ng/mL vs(1207.1606±525.2122) ng/mL, P<0.05]。Binary Logistic回归分析显示,血清鸢尾素(OR: 0.996,95%CI: 0.993~1.000,P=0.037)和CRP(OR: 0.701,95%CI: 0.499~0.985,P=0.041)是AMI患者PCI术后因心血管事件再入院的两个独立影响因素。ROC曲线分析表明,与单独的血清鸢尾素(AUC=0.858)相比,血清鸢尾素联合CRP对AMI患者PCI术后再次入院(AUCs=0.891)的预后价值更高。结论 血清鸢尾素水平能够助于预测急性ST段抬高型心肌梗死患者短期预后情况。
关键词:  ST段抬高心肌梗死  鸢尾素  经皮冠状动脉介入治疗  预后
DOI:10.16118/j.1008-0392.2019.06.017
投稿时间:2019-05-28
基金项目:国家自然科学基金面上项目(81670362)
Association between serum irisin levels and short-term prognosis in patients with acute myocardial infarction
ZHOU Zi-wei,QI Di,SIN Sathya,ZHOU Qiu-lian,XU Jia-hon
(Dept. of Cardiovascular Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China;Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China;School of Life Sciences, Shanghai University, Shanghai 200444, China)
Abstract:
Objective To investigate the association between serum irisin levels and short-term incidence of major cardiovascular adverse events(MACE) after percutaneous coronary intervention(PCI) in patients with acute myocardial infarction(AMI). Methods Seventy five patients with acute ST elevation myocardial infarction underwent PCI(AMI group), 36 patients with unstable angina pectoris(UAP group), and 35 subjects with normal coronary angiography examined in our hospital(healthy group) were enrolled in the study. All the participants underwent medical history collection, physical examination, blood chemistry tests; the serum irisin level was detected by ELISA method. Patients with AMI who underwent PCI were followed up for 6 months and the MACE events were documented. Results Serum irisin levels were significantly lower in AMI group than those in UAP+ healthy groups [(854.960±508.609) ng/mL vs.(1253.363±1059.100) ng/mL,P<0.05]. The serum irisin levels in AMI patients readmitted for MACE were significantly lower than those in non-readmitted AMI patients [(637.3404±320.4924) ng/mL vs.(1207.1606±525.2122) ng/mL, P<0.05]. Binary Logistic regression analysis showed that serum irisin level(OR: 0.996, 95%CI: 0.993-1.000,P=0.037) and CRP(OR: 0.701, 95%CI: 0.499-0.985,P=0.041) were independent risk factors for re-admission in AMI patients after PCI. ROC curve analysis indicated that serum irisin combined with CRP displayed better prognostic value for AMI patients readmission(AUC=0.891) compared to serum irisin alone(AUC=0.858). Conclusion Serum irisin level with CRP can predict short-term prognosis in patients with acute ST-segment elevation myocardial infarction after PCI.
Key words:  ST elevationmyocardial infarction  irisin  percutaneous coronary intervention  prognosis

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