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血浆同型半胱氨酸水平在急性心肌梗死预后评估中的应用研究(1)
http://www.100md.com 2019年9月25日 《中国医学创新》 2019年第27期
     【摘要】 目的:探讨血浆同型半胱氨酸(Hcy)水平在急性心肌梗死预后评估中的应用价值。方法:选取2017年6月-2018年6月在本院接受治疗100例急性心肌梗死患者,依据GRACE评分分为高危组(n=40)、中危组(n=30)和低危组(n=30),对比分析三组再次入院率、死亡率、Hcy及相关心功能指标水平。结果:高危组随访3个月再次入院率、死亡率均明显高于中危组与低危组(P<0.05)。治疗3个月后,左室舒张末期内径变化率(ΔLVEDD)、左室射血分数(LVEF)与左室舒张末期内径(LVEDD)均低于中危组与低危组(P<0.05);高危组Hcy、心衰定量标志物(BNP)水平、肌红蛋白(Myo)和心肌肌钙蛋白I(cTnI)均明显高于中危组和低危组(P<0.05)。结论:血浆Hcy水平是一种判断急性心肌梗死预后情况的主要参考指标,能够为患者疾病治疗和预后判断提供参考。

    【关键词】 同型半胱氨酸; 急性心肌梗死; 预后评估

    Application of Plasma Homocysteine Level Prognosis Evaluation of Acute Myocardial Infarction/CAO Zuofeng,HE Miao,LING Jiayuan.//Medical Innovation of China,2019,16(27):-121

    【Abstract】 Objective:To investigate the value of plasma homocysteine(Hcy)level in prognosis evaluation of acute myocardial infarction.Method:A total of 100 patients with acute myocardial infarction treated in our hospital from June 2017 to June 2018 were selected and divided into high-risk group(n=40),medium-risk group(n=30)and low-risk group(n=30)according to GRACE score.The readmission rate,mortality rate,Hcy and related cardiac function indexes of the three groups were compared and analyzed.Result:Followed up for 3 months,the readmission rate and mortality rate of the high-risk group were significantly higher than those of medium-risk group and low-risk group(P<0.05).After 3 months of treatment,the rate of left ventricular diastolic diameter change,left ventricular ejection fraction and left ventricular diastolic diameter were lower than those of the medium-risk group and low-risk group(P<0.05).Hcy,quantitative marker of heart failure(BNP),myoglobin(Myo)and cardiac troponin I(cTnI)in high-risk group were significantly higher than those in the medium-risk group and low-risk group(P<0.05).Conclusion:Hcy level is a major indicator to determine the prognosis of acute myocardial infarction,which can provide a reference for the treatment and prognosis of patients.

    【Key words】 Homocysteine; Acute myocardial infarction; Prognosis evaluation

    First-author’s address:First Affiliated Hospital of Gannan Medical College,Ganzhou 341000,China

    doi:10.3969/j.issn.1674-4985.2019.27.032

    隨着人们生活水平的逐步提高,冠心病在我国的发生率也呈现出逐年上升的趋势,急性心肌梗死所致死亡率也有所上升。吸烟、肥胖、高血脂、高血压均为常规临床上认可的冠心病高危影响因素,虽然上述高危因素已经得到了一定程度的控制,但仍有部分患者不具有上述常规的危险因素,医学研究结果证实,血浆同型半胱氨酸(Hcy)是一种独立的影响冠心病发生和发展的危险因素,尤其是急性心肌梗死患者的预后评估,其临床应用价值较高。Hcy内含有自由巯基,能够起到重要的生理功能,但其无法从食物中摄取,只能通过人体内必需氨基酸代谢产生。近几年来,有流行病学研究发现,当甲硫氨酸代谢途径出现障碍时,会导致血浆Hcy升高,是引起心血管疾病的独立危险性因素。本研究对血浆Hcy水平在急性心肌梗死预后评估中的应用价值进行了分析。现报道如下。, http://www.100md.com(曹佐锋 何苗 凌嘉源)
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