醛固酮水平对急性心肌梗死预后的影响

目的：探讨发病初期醛固酮水平对急性心肌梗死（AMI）预后的影响。方法：选取资料完整的AMI患者160例，进行分析。按入院时醛固酮水平分为3组：最低值组（〈123.4 pmol/L），中值组（123.4~160.3 pmol/L）和高值组（〉160.3 pmol/L）。比较各组心肌酶水平，心功能指标，室性心律失常发生率，住院及3年病死率。结果：①3组间住院病死率和3年病死率分别为低值组：4%，8%，中值组：5%，12%，高值组：12%，32%，高值组3年病死率与中低值组比较均有统计学意义（P〈0.01）。②3组间肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）及左室射血分数（LVEF）值，高值组分别与中低值组之间进行比较，差异有统计学意义（P〈0.05）。结论：AMI初期时高醛固酮水平患者的预后较差。

Effect of aldosterone level on the prognosis of acute myocardial infarction

AIM：To investigate the effect of aldosterone level in early onset on the prognosis of acute myocardial infarction （AMI）. METHODS： Data of AMI patients were analyzed in 160 cases （male 118 cases, female 42 cases）. According to the aldosterone levels, patients were divided into three groups： minimum value group （〈123.4 pmol/L）, median value group （123.4-160.3 pmol/L） and high value group （〉160.3 pmol/L）. The levels of myocardial enzyme, cardiac function index, incidence of ventricular arrhythmias and in hospital and 3 year mortality rates were compared. RESULTS： In hospital and 3-year mortality rate of minimum value group, medium value group and high value group were, respectively, 3.8% ＆ 11.6%, 7.7% ＆ 12.3%, and 4.6% ＆ 31.9%, and those in high value group were significantly different from those in minimum value group and medium value group （P〈0.01）. Creatine kinase （CK） and creatine kinase MB isoenzyme （CK-MB）, left ventricular ejection fraction （EF） and incidence of ventricular arrhythmia in the high value group were significantly different, respectively, from those in minimum value group and medium value group （P〈0.05）. CONCLUSION： High aldosterone levels at early onset exert a significant effect on the prognosis of AMI.