无症状性心肌梗死患者血清维生素、微量元素水平变化及其与疾病严重程度的相关性研究

背景近年来维生素、微量元素及酶类等与心血管疾病的关系逐渐受到临床关注,但目前关于维生素、微量元素与无症状性心肌梗死(SMI)发生发展关系的研究报道较少见。目的观察SMI患者血清维生素和微量元素水平变化,并分析其与疾病严重程度的相关性。方法选取2017年1月—2018年1月在梧州市人民医院心血管内科确诊的SMI患者80例作为观察组,其中Cohn分型Ⅰ型24例、Ⅱ型30例、Ⅲ型26例;另选取同期体检健康者20例作为对照组。比较两组受试者及不同Cohn分型患者血清维生素〔包括维生素A(VitA)、维生素D(VitD)、维生素E(VitE)〕及微量元素〔包括铁(Fe)、锌(Zn)、铜(Cu)〕水平;血清维生素、微量元素水平与SMI患者Cohn分型的相关性分析采用Spearman秩相关分析。结果(1)观察组患者血清VitA、VitD、VitE、Zn、Cu水平低于对照组,血清Fe水平高于对照组(P<0.05)。(2)Cohn分型Ⅱ型和Ⅲ型患者血清VitA、VitD、VitE、Zn、Cu水平低于Ⅰ型,血清Fe水平高于Ⅰ型(P<0.05);Cohn分型Ⅲ型患者血清VitA、VitD、VitE、Zn、Cu水平低于Ⅱ型,血清Fe水平高于Ⅱ型(P<0.05)。(3)Spearman秩相关分析结果显示,血清VitA(rs=-0.464)、VitD(rs=-0.789)、VitE(rs=-0.754)、Zn(rs=-0.567)、Cu(rs=-0.757)水平与SMI患者Cohn分型呈负相关(P<0.05),血清Fe水平与SMI患者Cohn分型呈正相关(rs=0.489,P<0.05)。结论SMI患者血清VitA、VitD、VitE、Zn、Cu水平升高,Zn水平降低,且血清VitA、VitD、VitE、Fe、Zn、Cu水平变化与SMI严重程度有关并可能参与SMI的发生发展过程。

Changes of Serum Levels of Vitamins and Microelements in Patients with Silent Myocardial Infarction and Their Correlations with Severity of Illness

Background Relations of vitamins,microelements and enzymes to cardiovascular diseases had attracted clinical attention in recent years,however there is few reports about relations of vitamins and microelements to occurrence and development of silent myocardial infarction(SMI)at present.Objective To observe the changes of serum levels of vitamins and microelements in patients with SMI,to analyze their correlations with severity of illness.Methods From January 2017 to January 2018,a total of 80 confirmed patients with SMI were selected as observation group in the Department of Cardiovascular Medicine,the People's Hospital of Wuzhou,thereinto 24 cases classified as Cohn typeⅠ,30 cases as Cohn typeⅡ,26 cases as Cohn typeⅢ;meanwhile 20 healthy people admitted to this hospital for physical examination were selected as control group.Serum levels of vitamins(including VitA,VitD and VitE)and microelements(including Fe,Zn and Cu)were compared between the two groups and in SMI patients with different Cohn types;Spearman rank correlation analysis was used to analyze the correlations of serum levels of vitamins and microelements with Cohn type in patients with SMI.Results(1)Serum levels of VitA,VitD,VitE,Zn and Cu in observation group were statistically significantly lower than those in control group,while serum Fe level in observation group was statistically significantly higher than that in control group(P<0.05).(2)Serum levels of VitA,VitD,VitE,Zn and Cu in patients with Cohn typeⅡorⅢwere statistically significantly lower than those in patients with Cohn typeⅠ,while serum Fe level in patients with Cohn typeⅡorⅢwas statistically significantly higher than that in patients with Cohn typeⅠ(P<0.05);serum levels of VitA,VitD,VitE,Zn and Cu in patients with Cohn typeⅢwere statistically significantly lower than those in patients with Cohn typeⅡ,while serum Fe level in patients with Cohn typeⅢwas statistically significantly higher than that in patients with Cohn typeⅡ(P<0.05).(3)Spearman rank correlation analysis results showed that,serum level of VitA(rs=-0.464),VitD(rs=-0.789),VitE(rs=-0.754),Zn(rs=-0.567)and Cu(rs=-0.757)was negatively correlated with Cohn type in patients with SMI,respectively(P<0.05),while serum Fe level was positively correlated with the Cohn type(rs=0.489,P<0.05).Conclusion Serum levels of VitA,VitD,VitE,Zn and Cu significantly elevate but serum Fe level significantly decreases in patients with SMI,moreover changes of serum levels of VitA,VitD,VitE,Fe,Zn and Cu are statistically correlated with the severity of SMI,which may be involved in the occurrence and development of SMI.