摘要
目的探讨血浆脂蛋白相关磷脂酶A2(Lp-PLA2)、心形脂肪酸结合蛋白(H-FABP)、细胞间隙连接蛋白43(Cx43)与急性心肌梗死(AMI)患者经皮冠脉介入术(PCI)后发生不良心血管事件(MACE)的关系。方法回顾性选取2019年8月至2022年8月在海南医学院第一附属医院实施PCI治疗后且发生MACE事件的53例患者作为MACE组,选取同期PCI治疗的AMI且未发生MACE患者80例作为对照组。比较两组患者入院后24 h内的Lp-PLA2、H-FABP、Cx43、血常规指标、心肌酶学指标、血脂指标水平,患者植入支架情况等,采用Logistic模型分析影响AMI患者PCI术后发生MACE事件的相关因素。结果MACE组的Lp-PLA2、H-FABP、中性粒细胞计数与淋巴细胞的比值(NLR)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、总胆固醇为(236.80±56.80)μg/L、(120.66±20.16)μg/L、4.82±1.33、(90.77±27.04)U/L、(12.66±1.94)μg/L、(5.58±0.84)mmol/L,均高于对照组[(201.60±55.1)μg/L、(96.40±14.18)μg/L、3.92±1.20、(74.18±22.60)U/L、(11.40±1.82)μg/L、(5.26±0.90)mmol/L],Cx43、高密度脂蛋白胆固醇(HDL-C)为(98.77±19.30)pg/mL、(0.98±0.14)mmol/L,低于对照组[(130.16±24.66)pg/mL、(1.10±0.16)mmol/L],差异均有统计学意义(P<0.05);MACE组和对照组的血红蛋白、白细胞计数、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、植入支架数目、支架总长度比较,差异均无统计学意义(P>0.05)。MACE组的植入支架数目、支架总长度与对照组比较,差异均无统计学意义(P>0.05)。Logistic回归模型结果显示:年龄增大、NYHA分级≥Ⅱ级、Lp-PLA2升高、H-FABP升高、Cx43降低、NLR升高、HDL-C降低是AMI患者发生MACE的独立危险因素(P<0.05)。结论AMI患者PCI后发生MACE的患者Lp-PLA2、H-FABP水平显著高于非MACE患者,Cx43低于非MACE患者,Lp-PLA2、H-FABP、Cx43水平与患者发生MACE事件关系密切。
Objective To investigate the relationship between plasma lipoprotein-associated phospholipase A2(Lp-PLA2),heart-shaped fatty acid-binding protein(H-FABP),intercellular gap junction protein 43(Cx43)and percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI)after adverse cardiovascular events(MACE).Methods In this study,53 patients with MACE events after PCI in the First Affiliated Hospital of Hainan Medical University from August 2019 to August 2022 were selected as the MACE group,and 80 patients with AMI treated by PCI during the same period without MACE were selected as the control group,and the two groups were compared.Lp-PLA2,H-FABP,Cx43,blood routine indexes,myocardial enzyme indexes,blood lipid indexes,stent implantation status of patients within 24 hours after admission,logistic model was used to analyze the correlation between MACE events after PCI in AMI patients factor.Results Lp-PLA2,H-FABP,neutrophil/lymphocyte ratio(NLR),creatine kinase isoenzyme(CK-MB),troponin I(cTnI)and total cholesterol in MACE group were(236.80±56.80)μg/L,(120.66±20.16)μg/L,4.82±1.33,(90.77±27.04)U/L,(12.66±1.94)μg/L,(5.58±0.84)mmol/L,which were higher than those in the control group[(201.60±55.10)μg/L,(96.40±14.18)μg/L,3.92±1.20,(74.18±22.60)U/L,(11.40±1.82)μg/L,(5.26±0.90)mmol/L],Cx43,high-density lipoprotein cholesterol(HDL-C)were(98.77±19.30)pg/mL,(0.98±0.14)mmol/L,which were lower than those in the control group[(130.16±24.66)pg/mL,(1.10±0.16)mmol/L],the differences were statistically significant(P<0.05);there was no statistically significant difference between the MACE group and the control group in hemoglobin,leukocyte count,triglyceride,low-density lipoprotein cholesterol(LDL-C),the number of implanted stents,and the total length of the stent between the MACE group and the control group(P>0.05).The number of implanted stents and total length of stents in the MACE group were not significantly different from those in the control group(P>0.05).High level,increased H-FABP,decreased Cx43,increased NLR,and decreased HDL-C were independent risk factors for MACE in patients with AMI(P<0.05).Conclusion The levels of Lp-PLA2 and H-FABP in patients with MACE after PCI in AMI patients were significantly higher than those in non-MACE patients,and Cx43 was lower than that in non-MACE patients,which was closely related to the occurrence of MACE events in patients.
作者
邢孔玉
凌学斌
高飞
钟丹萍
黄贝霞
黎海江
XING Kong-yu;LING Xue-bin;GAO Fei(Department of Cardiovascular Medicine,2 Department of Laboratory,The First Affiliated Hospital of Hainan Medical University,Haikou Hainan 570100,China)
出处
《临床和实验医学杂志》
2023年第3期250-254,共5页
Journal of Clinical and Experimental Medicine
基金
海南省自然科学基金(编号:821QN0986)。
作者简介
通讯作者:黎海江,E-mail:601992793@qq.com。
