急性心肌梗死心室重构及心功能与脂联素水平的相关性研究

目的 分析急性心肌梗死(AMI)患者血清脂联素(APN)水平与心室重构及心功能的关系.方法 对我院心内科CCU病房2004-07～2008-10收治的270例资料完整的AMI患者进行了回顾性分析,根据患者入院后24～48 h血清APN水平最高值分为三组,即A组(APN水平≥8.5 mg/L)、B组(APN水平5.5～8.5 mg/L)和C组(APN水平≤5.5 mg/L),比较各组心肌酶、心肌梗死面积、心功能及住院病死率.结果 ①住院病死率:A组8%(5/66),B组8%(13/161),C组21%(9/43),C组显著高于A组和B组(P<0.05).②肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)和心肌梗死面积:C组高于A组和B组(P<0.05).③住院期间死亡27例,存活243例,存活组和死亡组血清APN水平分别为(6.1±1.2)mg/L和(3.6±1.3)mg/L,两组比较差异有统计学意义(P<0.01).④对AMI后30 d住院期间死亡危险因素进行多因素Logistic回归分析发现,血清APN水平与AMI后30 d住院期间病死率相关,30 d住院期间病死率随着血清APN水平降低而升高.结论 血清APN水平可能与AMI预后具有相关性.

Relationship between ventricular remodeling, heart function and adiponectin in the patients with acute myocardial infarction

Objective To evaluate the relationship between ventricular remodeling, heart func-tion and adiponectin in the patients with acute myocardial infarction ( AMI). Methods 270 patients with AMI in Coronary Care Unit of our hospital from July 2004 to October 2008 were divided into three groups according to serum adiponectin concentration within 24～48 hours following the onset of AMI: group A, adiponectin≥8. 5 mg/L;group B, adiponectin 5.5～8.5 mg/L; group C, adiponectin≤5. 5 mg/L. The data of myocardial enzymes, myocardial infarction size, heart function and inhospital mortali-ty were analyzed respectively. Results ①The inhospital mortality of each group : group A was 8% (5/ 66) , group B was 8% (13/161), group C was 21% (9/43). The difference was significant between group C and group B, group A ( P < 0. 05). ②There were significant differences in the activities of serum creatine kinase, serum creatine kinase isoenzymes - MB and myocardial infarction size among the 3 groups (P < 0. 05).③27 cases died and 243 cases recovered in the duration of hospital stay. Serum adiponectin concentrations were (6. 1±1.2) mg/L in the survival and ( 3. 6±1. 3) mg/L in the dead (P<0. 01). ④In a multivariate Logistic regression analysis, serum adiponectin was associated with 30 - day mortality in the patients with AMI. In analysis of the correlation between the level of serum adi-ponectin and outcome, we observed that the risk of 30-day mortality increased with the severity of de-creased serum adiponectin levels. Conclusion The prognosis in the patients with AMI may be related to serum adiponectin levels.