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目的:检测急性心肌梗死(心梗)患者的血清铁蛋白水平,分析其对患者预后的判断价值。方法 :检测610例急性心梗患者的血清铁蛋白水平,并按结果的四分位间距将其分为低水平组、较低水平组、较高水平组和高水平组,比较各组间的主要不良心血管事件(major adverse cardiovascular events,MACE)发生率;再按随访期(6个月)是否发生MACE分为有事件组(108例)和无事件组(502例),采用多因素Cox回归分析血清铁蛋白水平对急性心梗患者预后的影响。结果:血清铁蛋白高水平组(≥348 ng/m L)的心血管事件发生率最高,达33.1%,显著高于低水平组、较低水平组及较高水平组(P均<0.05)。与无事件组比较,有事件组患者的年龄较大,血清铁蛋白、峰值肌钙蛋白和血肌酐水平显著增高,高密度脂蛋白及左心室射血分数降低,合并糖尿病、冠状动脉多支病变的概率升高(P<0.05)。Cox回归分析显示,高水平血清铁蛋白(≥348 ng/m L)、年龄(>65岁)、合并糖尿病是首次发生急性心梗患者6个月内发生MACE的独立危险因素(P<0.05)。结论:血清铁蛋白水平检测对首次发生急性心梗患者可能具有一定的临床预后评估价值。
Objective: To detect the level of serum ferritin in patients with acute myocardial infarction (MI), and to analyze its value of prognosis of patients. Methods: The levels of serum ferritin in 610 acute myocardial infarction patients were detected and divided into low-level group, low-level group, high-level group and high-level group according to the interquartile range of the results. The incidence of major adverse cardiovascular events (MACE) was compared. The incidence of MACE in the follow-up period (6 months) was divided into the event group (108 cases) and the event-free group (502 cases) Regression analysis of serum ferritin levels in patients with acute myocardial infarction prognosis. Results: The incidence of cardiovascular events was the highest (≥348 ng / m L) in the high serum ferritin group (33.1%), which was significantly higher than that in the low, middle and high levels (all P <0.05) . Compared with the non-event group, patients in the event group were older, serum ferritin, peak troponin and serum creatinine levels were significantly increased, high density lipoprotein and left ventricular ejection fraction decreased, with diabetes, multiple coronary artery disease (P <0.05). Cox regression analysis showed that high-level serum ferritin (≥348 ng / m L), age (> 65 years), and diabetes mellitus were independent risk factors for MACE within 6 months of first-episode AMI (P <0.05) . Conclusion: The detection of serum ferritin level may have certain clinical prognostic value in patients with acute myocardial infarction for the first time.