血清淀粉样蛋白A1在急性心梗中的早期诊断及预后

摘要] 目的：本研究探讨SAA1表达水平与急性心肌梗死及其预后的相关性，以及急性心肌梗死患者、不稳定心绞痛患者、稳定性心绞痛患者与健康人群的差异性表达。方法：选取2016年10月至2018年7月于我院行冠状动脉造影术的110例患者和健康体检的30例患者，作为研究对象；其中急性心肌梗死组（AMI组）50人，不稳定心绞痛组（UA组）32人，稳定性心绞痛组（SAP组）28人，正常组（CON组）30人；其中急性心肌梗死组分为发病当天（AMI0组）及入院7天组（AMI7组），对比各组间SAA1指标的差异性。并收集患者的一般资料及相关化验检查。Pearson相关分析方法分析HDL-C及BNP水平与急性心梗组SAA1水平的相关性；同时初步探究SAA1水平与心梗后心功能不全发生风险的相关性。结果：AMI组SAA1水平明显高于其他三组（UAP、SAP、CON组），两两比较均具有统计学意义（P=0.000）；UA组SAA1水平明显高于CON组，且高于SAP组，两两比较均有统计学差异（P=0.047，P=0.009）； SAP组与CON组差异无统计学意义（P=0.507）。 BNP升高水平同AMI组中SAA1水平具有明确正相关（r=0.421，P=0.045）；HDL-C水平同AMI组中SAA1水平具有明确负相关（r=-0.445，P=0.033）；而LDL-C及cTnI同AMI组中SAA1水平无统计学差异（r=0.015,P=0.945;r=-0.171,P=0.436）。AMI0组SAA1水平明显高于AMI7组，差异存在统计学意义（P=0.002）。结论：SAA1蛋白在急性心肌梗死、不稳定心绞痛、稳定性心绞痛与健康人群中存在明显差异。在急性心梗组中SAA1升高水平与BNP呈正相关，提示心梗后心衰风险升高。 SAA1蛋白在急性心肌梗死中发病当天及7天后存在的明显差异。

Early diagnosis and prognosis of serum amyloid A1 in acute myocardial infarction

Objective: This study investigated the correlation between SAA1 expression levels and acute myocardial infarction and its prognosis, as well as differential expression of patients with acute myocardial infarction, unstable angina, stable angina and healthy people.Methods: 110 patients who underwent coronary angiography in our hospital from October 2016 to July 2018 and 30 patients who underwent physical examination were included in the study. Among them, 50 patients in the acute myocardial infarction group (AMI group), unstable angina group There were 32 patients in the UA group, 28 in the stable angina group (SAP group), and 30 in the normal group (CON group). The acute myocardial infarction component was the day of onset (AMI0 group) and the 7-day admission group (AMI7 group). The differences in SAA1 indicators between groups were compared. Collect general patient information and related laboratory tests. Pearson correlation analysis method was used to analyze the correlation between HDL-C and BNP levels and SAA1 levels in acute myocardial infarction group. At the same time, the correlation between SAA1 level and the risk of cardiac insufficiency after myocardial infarction was initially explored.Results: The level of SAA1 in the AMI group was significantly higher than that in the other three groups (UAP, SAP, CON) (P=0.000). The level of SAA1 in the UA group was significantly higher than that in the CON group, and higher than the SAP group. Statistical difference (P=0.047, P=0.009); There was no significant difference between SAP group and CON group (P=0.507). The elevated level of BNP was positively correlated with the level of SAA1 in the AMI group (r=0.421, P=0.045); the level of HDL-C was significantly negatively correlated with the level of SAA1 in the AMI group (r=-0.445, P=0.033); There was no difference in the levels of SAA1 between LDL-C and cTnI in the AMI group (r=0.015, P=0.945; r=-0.171, P=0.436). The level of SAA1 in the AMI0 group was significantly higher than that in the AMI7 group (P=0.002).Conclusion: SAA1 protein is significantly different between acute myocardial infarction, unstable angina, stable angina and healthy people. In patients with acute myocardial infarction, elevated SAA1 was positively correlated with BNP in the AMI group, suggesting an increased risk of heart failure after myocardial infarction. There was a significant difference in the SAA1 protein on the day of onset and after 7 days in acute myocardial infarction.