CAJ | 학술논문

目的：探讨急性心肌梗死(AMI)合并2型糖尿病(T2DM)患者血清脂蛋白a(Lp-a)、尿酸(UA)的水平及其与患者心、肾功能及预后的关系。方法选取2010年1月~2014年6月广东省云浮市人民医院收治的75例AMI合并T2DM患者(AMI合并T2DM组)、50例单纯AMI患者(AMI组)、50例单纯T2DM患者(T2DM组)、50例健康人群(对照组)为研究对象。检测各组血清Lp-a、UA水平；比较分析不同心、肾功能及预后的AMI合并T2DM患者的Lp-a及UA水平；分析年龄、BMI、心功能、肾功能、预后与患者的Lp-a及UA水平的相关性。结果 AMI合并T2DM组血清Lp-a、UA水平均高于AMI组、T2DM组及对照组，差异均有高度统计学意义(P<0.01)；AMI组、T2DM组血清Lp-a、UA水平均高于对照组，差异均有高度统计学意义(P<0.01)。心功能Ⅲ~Ⅳ级者血清Lp-a、UA水平均高于Ⅰ~Ⅱ级者，差异均有高度统计学意义(P<0.01)；随着AMI合并T2DM患者肾功能的恶化，血清Lp-a、UA水平呈逐渐增加趋势，差异均有高度统计学意义(P<0.01)；有心血管事件者血清Lp-a、UA水平高于无心血管事件者，差异有高度统计学意义(P<0.01)。在AMI合并T2DM患者中，血清Lp-a、UA表达与患者的心功能分级均呈正相关(r=0.461，0.481，均P<0.05)；血清Lp-a、UA表达与患者肾功能(r=-0.517，-0.496；均P<0.05)及预后(r=-0.508，-0.490，均P<0.05)均呈负相关；血清Lp-a、UA之间均正相关(r=0.494，P<0.05)。结论 AMI合并T2DM患者血清中Lp-a、UA均呈高表达，随着AMI合并T2DM患者肾功能、心功能及预后的恶化，血清Lp-a、UA的表达呈逐渐增高趋势，血清Lp-a、UA的表达与AMI合并T2DM的发病、肾功能、心功能及预后密切相关，可以作为诊断AMI合并T2DM及监测病情进展的指标。
목적：탐토급성심기경사(AMI)합병2형당뇨병(T2DM)환자혈청지단백a(Lp-a)、뇨산(UA)적수평급기여환자심、신공능급예후적관계。방법선취2010년1월~2014년6월광동성운부시인민의원수치적75례AMI합병T2DM환자(AMI합병T2DM조)、50례단순AMI환자(AMI조)、50례단순T2DM환자(T2DM조)、50례건강인군(대조조)위연구대상。검측각조혈청Lp-a、UA수평；비교분석불동심、신공능급예후적AMI합병T2DM환자적Lp-a급UA수평；분석년령、BMI、심공능、신공능、예후여환자적Lp-a급UA수평적상관성。결과 AMI합병T2DM조혈청Lp-a、UA수평균고우AMI조、T2DM조급대조조，차이균유고도통계학의의(P<0.01)；AMI조、T2DM조혈청Lp-a、UA수평균고우대조조，차이균유고도통계학의의(P<0.01)。심공능Ⅲ~Ⅳ급자혈청Lp-a、UA수평균고우Ⅰ~Ⅱ급자，차이균유고도통계학의의(P<0.01)；수착AMI합병T2DM환자신공능적악화，혈청Lp-a、UA수평정축점증가추세，차이균유고도통계학의의(P<0.01)；유심혈관사건자혈청Lp-a、UA수평고우무심혈관사건자，차이유고도통계학의의(P<0.01)。재AMI합병T2DM환자중，혈청Lp-a、UA표체여환자적심공능분급균정정상관(r=0.461，0.481，균P<0.05)；혈청Lp-a、UA표체여환자신공능(r=-0.517，-0.496；균P<0.05)급예후(r=-0.508，-0.490，균P<0.05)균정부상관；혈청Lp-a、UA지간균정상관(r=0.494，P<0.05)。결론 AMI합병T2DM환자혈청중Lp-a、UA균정고표체，수착AMI합병T2DM환자신공능、심공능급예후적악화，혈청Lp-a、UA적표체정축점증고추세，혈청Lp-a、UA적표체여AMI합병T2DM적발병、신공능、심공능급예후밀절상관，가이작위진단AMI합병T2DM급감측병정진전적지표。
Objective To study the expression of serum Lp-a, UA of Patients with AMI combined with T2DM and the correlation with cardiac function, renal function and prognosis. Methods From January 2010 to June 2014 in the Peo-ple's Hospital of Yunfu City, 77 patients of AMI combined with T2DM (AMI combined with T2DM group), and 50 cases with AMI (AMI group) and 50 cases with T2DM (T2DM group) were selected as disease control group, and 50 cases of healthy people (control group) were selected as the research object. Levels of serum Lp-a and UA of each groups were detected; levels of UA and Lp-a in AMI patients combined with T2DM with different function of heart and renal, and different prognosis were compared and analyzed; the correlation between age, BMI, heart function, renal function, prog-nosis and levels of Lp-a, UA were analyzed. Results Levels of serum Lp-a, UA in AMI combined with T2DM group were higher than that in AMI group, T2DM group and the control group, and the differences were statistically significant (P< 0.01); and levels of serum Lp-a, UA in the AMI group, T2DM group were higher than the control group, and the differences were statistically significant (P<0.01). Levels of Lp-a, UA in patients with cardiac function of gradeⅢ-Ⅳwere higher than in gradeⅠ-IIgroup, and the differences were statistically significant (P<0.01);with the deterioration of renal function in AMI combined with T2DM patients, levels of serum Lp-a, UA showed a trend of increasing gradu-ally, and the differences were statistically significant (P<0.01); Serum Lp-a, UA levels in patients with cardiovascular events were higher than those without cardiovascular events, and the differences were statistically significant (P<0.01). In AMI patients combined with T2DM, the expression of serum Lp-a, UA were positively correlated with heart functionclassification (r=0.461, 0.481, all P<0.05), while negatively correlated with renal function (r=-0.517,-0.496, all P<0.05) and prognosis (r= -0.508, -0.490, all P<0.05); the levels of serum Lp-a was positively correlated with UA (r =0.494, P< 0.05). Conclusion Serum Lp-a, UA in AMI combined with T2DM patients have high expression, and with the deterioration of renal function and cardiac function, the expression of serum Lp-a and UA trends to increase gradu-ally. The expression of serum Lp-a and UA are closely related to renal function, heart function, prognosis in AMI com-bined with T2DM patients, and will be a diagnostic index of AMI with T2DM to monitor the disease progression.