血浆同型半胱氨酸水平在急性心肌梗死预后评估中的应用研究(1)
【摘要】 目的：探讨血浆同型半胱氨酸(Hcy)水平在急性心肌梗死预后评估中的应用价值。方法：选取2017年6月-2018年6月在本院接受治疗100例急性心肌梗死患者，依据GRACE评分分为高危组(n=40)、中危组(n=30)和低危组(n=30)，对比分析三组再次入院率、死亡率、Hcy及相关心功能指标水平。结果：高危组随访3个月再次入院率、死亡率均明显高于中危组与低危组(P<0.05)。治疗3个月后，左室舒张末期内径变化率(ΔLVEDD)、左室射血分数(LVEF)与左室舒张末期内径(LVEDD)均低于中危组与低危组(P<0.05)；高危组Hcy、心衰定量标志物(BNP)水平、肌红蛋白(Myo)和心肌肌钙蛋白I(cTnI)均明显高于中危组和低危组(P<0.05)。结论：血浆Hcy水平是一种判断急性心肌梗死预后情况的主要参考指标，能够为患者疾病治疗和预后判断提供参考。
【关键词】 同型半胱氨酸； 急性心肌梗死； 预后评估
Application of Plasma Homocysteine Level Prognosis Evaluation of Acute Myocardial Infarction/CAO Zuofeng，HE Miao，LING Jiayuan.//Medical Innovation of China，2019，16(27)：-121
【Abstract】 Objective：To investigate the value of plasma homocysteine(Hcy)level in prognosis evaluation of acute myocardial infarction.Method：A total of 100 patients with acute myocardial infarction treated in our hospital from June 2017 to June 2018 were selected and divided into high-risk group(n=40)，medium-risk group(n=30)and low-risk group(n=30)according to GRACE score.The readmission rate，mortality rate，Hcy and related cardiac function indexes of the three groups were compared and analyzed.Result：Followed up for 3 months，the readmission rate and mortality rate of the high-risk group were significantly higher than those of medium-risk group and low-risk group(P<0.05).After 3 months of treatment，the rate of left ventricular diastolic diameter change，left ventricular ejection fraction and left ventricular diastolic diameter were lower than those of the medium-risk group and low-risk group(P<0.05).Hcy，quantitative marker of heart failure(BNP)，myoglobin(Myo)and cardiac troponin I(cTnI)in high-risk group were significantly higher than those in the medium-risk group and low-risk group(P<0.05).Conclusion：Hcy level is a major indicator to determine the prognosis of acute myocardial infarction，which can provide a reference for the treatment and prognosis of patients.
【Key words】 Homocysteine； Acute myocardial infarction； Prognosis evaluation
First-author’s address：First Affiliated Hospital of Gannan Medical College，Ganzhou 341000，China
doi：10.3969/j.issn.1674-4985.2019.27.032
隨着人们生活水平的逐步提高，冠心病在我国的发生率也呈现出逐年上升的趋势，急性心肌梗死所致死亡率也有所上升。吸烟、肥胖、高血脂、高血压均为常规临床上认可的冠心病高危影响因素，虽然上述高危因素已经得到了一定程度的控制，但仍有部分患者不具有上述常规的危险因素，医学研究结果证实，血浆同型半胱氨酸(Hcy)是一种独立的影响冠心病发生和发展的危险因素，尤其是急性心肌梗死患者的预后评估，其临床应用价值较高。Hcy内含有自由巯基，能够起到重要的生理功能，但其无法从食物中摄取，只能通过人体内必需氨基酸代谢产生。近几年来，有流行病学研究发现，当甲硫氨酸代谢途径出现障碍时，会导致血浆Hcy升高，是引起心血管疾病的独立危险性因素。本研究对血浆Hcy水平在急性心肌梗死预后评估中的应用价值进行了分析。现报道如下。, http://www.100md.com(曹佐锋 何苗 凌嘉源)
【关键词】 同型半胱氨酸； 急性心肌梗死； 预后评估
Application of Plasma Homocysteine Level Prognosis Evaluation of Acute Myocardial Infarction/CAO Zuofeng，HE Miao，LING Jiayuan.//Medical Innovation of China，2019，16(27)：-121
【Abstract】 Objective：To investigate the value of plasma homocysteine(Hcy)level in prognosis evaluation of acute myocardial infarction.Method：A total of 100 patients with acute myocardial infarction treated in our hospital from June 2017 to June 2018 were selected and divided into high-risk group(n=40)，medium-risk group(n=30)and low-risk group(n=30)according to GRACE score.The readmission rate，mortality rate，Hcy and related cardiac function indexes of the three groups were compared and analyzed.Result：Followed up for 3 months，the readmission rate and mortality rate of the high-risk group were significantly higher than those of medium-risk group and low-risk group(P<0.05).After 3 months of treatment，the rate of left ventricular diastolic diameter change，left ventricular ejection fraction and left ventricular diastolic diameter were lower than those of the medium-risk group and low-risk group(P<0.05).Hcy，quantitative marker of heart failure(BNP)，myoglobin(Myo)and cardiac troponin I(cTnI)in high-risk group were significantly higher than those in the medium-risk group and low-risk group(P<0.05).Conclusion：Hcy level is a major indicator to determine the prognosis of acute myocardial infarction，which can provide a reference for the treatment and prognosis of patients.
【Key words】 Homocysteine； Acute myocardial infarction； Prognosis evaluation
First-author’s address：First Affiliated Hospital of Gannan Medical College，Ganzhou 341000，China
doi：10.3969/j.issn.1674-4985.2019.27.032
隨着人们生活水平的逐步提高，冠心病在我国的发生率也呈现出逐年上升的趋势，急性心肌梗死所致死亡率也有所上升。吸烟、肥胖、高血脂、高血压均为常规临床上认可的冠心病高危影响因素，虽然上述高危因素已经得到了一定程度的控制，但仍有部分患者不具有上述常规的危险因素，医学研究结果证实，血浆同型半胱氨酸(Hcy)是一种独立的影响冠心病发生和发展的危险因素，尤其是急性心肌梗死患者的预后评估，其临床应用价值较高。Hcy内含有自由巯基，能够起到重要的生理功能，但其无法从食物中摄取，只能通过人体内必需氨基酸代谢产生。近几年来，有流行病学研究发现，当甲硫氨酸代谢途径出现障碍时，会导致血浆Hcy升高，是引起心血管疾病的独立危险性因素。本研究对血浆Hcy水平在急性心肌梗死预后评估中的应用价值进行了分析。现报道如下。, http://www.100md.com(曹佐锋 何苗 凌嘉源)