血清丙氨酸转氨酶与ST段抬高型心肌梗死的相关性研究

目的：探讨血清丙氨酸转氨酶（ALT）与急性ST段抬高型心肌梗死（STEMI）的临床意义,进一步研究ALT是否为STEMI患者的预测因素.方法：选择心脏科住院患者909例,分为对照组患者（无冠心病患者）355例,急性STEMI患者554例,其亚组分型包括：（1）依据血管病变程度分组（单支组154例,双支组176例,多支组224例）;（2）依据心肌梗死发病到空腹抽血时间分组（0～24 h组296例,24～48 h组124例,超过48 h组134例）.统计所有入选患者的基本临床资料、生化资料及冠脉造影资料,回顾性分析ALT与急性心肌梗死的相关性.结果：急性STEMI组与对照组在年龄、尿素氮、肌酐、天冬氨酸转氨酶、ALT、高密度脂蛋白等有明显统计学差异（P＜0.01）;在急性STEMI患者亚组分析中,ALT与急性STEMI患者血管病变的严重程度有统计学意义（P＜0.05）,且患者ALT在空腹抽血时间（从心梗发病计算）上有明显的统计学差异（P＜0.01）;Logistic回归分析结果示ALT（OR=0.911）、年龄（OR=1.068）、肌酐（OR=1.041）、天冬氨酸转氨酶（OR=1.270）是急性STEMI的危险预测因素.结论：ALT与急性STEMI密切相关,ALT是急性STEMI患者新的预测因素.

Clinical study of serum alanine aminotransferase in patients with acute ST-segment elevation myocardial infarction

Objective： To explore the association between serum alanine aminotransferase （ALT） and acute ST-segment elevation myocardial infarction （STEMI）, and also to investigate whether ALT is the new risk predictor for acute STEMI. Methods： A total of 909 patients were included in the analysis. Coronary angiography was the gold standard for diagnosis of coronary heart disease. The complement inhibition treated with angiography evaluated 554 patients with STEMI and 355 patients without coronary heart disease （control group）. There were two different subgroups divided inpatients with STEMI （1）According to the degree of coronary lesions, there were 154, 176 and 224 cases with single -branch group,double -branch group and multi-branch group respectively; （2）According to the time from AMI to fasting blood , three subgroups were divided （0-24 h：296 cases ,24-48 h： 124 cases,and more than 48 h ：134 cases）.The basic clinical data, biochemical data and coronary angiography were prospectively collected from the Department of Cardiology, especially STEMI from cardiac ICU. Results： Compared with control group, there were statistically significance in age, blood urea nitrogen, creatinine, aspartate aminotransferase （AST）, ALT, high density lipoprotein （P〈0.01）; In subgroups analysis closely association with the degree of coronary stenosis （P〈O.05） and with the time from AMI to fasting blood was tested in patients with STEMI （P〈0.01）.The risk predictors of STEMI were age（OR= 1.068）, AST（OR=l.270）,Cr（OR=l.041） and ALT（OR=0.911） from logistic regression analysis. Conclusion： ALT is closely associated with acute STEMI, ALT is not only new risk predictor for acute STEMI but also a positive diagnostic value for acute myocardial infarction.