急性冠脉综合征患者血清钙浓度与急性心肌梗死的相关性

 目的 探讨急性冠脉综合征(acute coronary syndrome,ACS)患者血清钙浓度的变化,探讨血清钙浓度与急性心肌梗死(acute myocardial infarction,AMI)的相关性。方法 选择2019年6-7月首都医科大学附属北京天坛医院心内科病房收治的ACS患者247例。收集患者的临床资料,采集血标本行血清钙等生化指标检测。采用二元logistic回归分析AMI的相关危险因素。结果 247例ACS患者分为两组,不稳定性心绞痛组149例,年龄(62.88±9.91)岁;AMI组98例,年龄(60.21±10.86)岁。AMI组患者的血清钙(2.21±0.11)mmol/L,明显低于不稳定性心绞痛组(2.25±0.09)mmol/L(P＜0.001)。Logistic回归分析显示,校正性别、心率、血白蛋白、总胆固醇、血磷等混杂因素后,血清钙四分位数(OR 0.591,95%CI 0.399~0.874,P=0.008)、年龄(OR 0.834, 95%CI 0.791~0.898, P＜0.001)、血红蛋白(OR 1.048, 95%CI 1.017~1.079, P=0.002)、低密度脂蛋白胆固醇(OR 2.532, 95%CI 1.544 ~4.151, P＜0.001)、GRACE评分(OR 1.129, 95%CI 1.092~1.167, P＜0.001)是AMI的独立危险因素。结论 与不稳定性心绞痛患者相比,AMI患者表现出较低的血清钙浓度,血清钙水平降低是AMI的独立危险因素。

Correlations between serum calcium levels and acute myocardial infarction in patients with acute coronary syndrome

Objective To study the changes of serum calcium levels in patients with acute coronary syndrome (ACS), and to explore the correlations between serum calcium and acute myocardial infarction (AMI). Methods A total of 247 ACS patients who were admitted to the Department of Cardiology, Beijing Tiantan Hospital, between June 2019 and July 2019 were enrolled. The clinical data on these patients was collected. Blood samples were drawn to measure serum calcium levels and other biochemical parameters. Binary Logistic regression was used to analyze the risk factors for AMI. Results The 247 ACS patients were divided into two groups: the unstable angina pectoris group (n=149) aged (62.88±9.91) years and the AMI group (n=98) aged (60.21±10.86) years. The serum calcium level in the AMI group (2.21±0.11) mmol/L was significantly lower than that of the unstable angina group (2.25±0.09) mmol/L (P<0.001). Logistic regression analysis showed that after adjusting for confounding factors such as gender, heart rate, serum albumin, total cholesterol and blood phosphorus, the quartile of serum calcium (OR 0.591, 95% CI 0.399-0.874,P=0.008), age (OR 0.834, 95% CI 0.791-0.898, P<0.001), hemoglobin (OR 1.048, 95% CI 1.017-1.079, P=0.002), low density lipoprotein cholesterol (OR 2.532,95% CI 1.544-4.151, P<0.001) and GRACE score (OR 1.129, 95% CI 1.092-1.167, P<0.001) were independent risk factors for AMI. Conclusions Compared with patients with unstable angina pectoris, AMI patients may show lower levels of serum calcium. A reduced level of serum calcium is an independent risk factor for AMI.