CAJ | 학술논문

目的观察急性心肌梗死(AMI)患者的前白蛋白水平,研究其与AMI的病变严重程度的相关性,为早期诊断和检测该病提供依据. 方法整群选取2011年3月—2013年11月至该科就诊的急性心肌梗死的患者112例为观察组,均行冠脉造影, 其结果示单支、2支及3支血管病变的病例数分别为 39、37及36例; 观察组分为发生心血管事件42例和未发生者70例;再随机将同时期到该院进行体检的50名患者设为对照组;分别检测并观察两组的前白蛋白差异、观察组内病变不同严重程度的前白蛋白差异及是否发生心血管事件与前白蛋白水平的联系. 检测两组的血清前白蛋白水平使用免疫比浊法.结果观察组的前白蛋白水平有显著下降,[(0.21±0.07) g/L vs (0.30±0.05) g/L, P<0.05];对照组与观察组的前白蛋白水平正常率有明显差异(100.0% vs 29.3%, P<0.05);单支、2支和3 支冠脉受累的患者,其前白蛋白水平逐渐下降[(0.25±0.06) g/L vs (0.21±0.06) g/L vs (0.18±0.05) g/L, P<0.05];根据Spearman相关分析,冠脉病变的严重程度与血清前白蛋白水平呈负相关(r=-0.233, P<0.05);未发生心血管事件者相比发生心血管事件者,其前白蛋白水平呈较高水平[(0.24±0.07)g/L vs (0.18±0.06) g/L,P<0.05].结论当急性心梗发作后,患者的前白蛋白水平有显著的下降,且其降低的幅度与病变的严重程度相关,可能与患者的预后有关,故可作为指标来对心梗患者的病情变化进行检测和预后进行判断.
목적 관찰급성심기경사(AMI)환자적전백단백수평,연구기여AMI적병변엄중정도적상관성,위조기진단화검측해병제공의거. 방법 정군선취2011년3월—2013년11월지해과취진적급성심기경사적환자112례위관찰조,균행관맥조영, 기결과시단지、2지급3지혈관병변적병례수분별위 39、37급36례; 관찰조분위발생심혈관사건42례화미발생자70례;재수궤장동시기도해원진행체검적50명환자설위대조조;분별검측병관찰량조적전백단백차이、관찰조내병변불동엄중정도적전백단백차이급시부발생심혈관사건여전백단백수평적련계. 검측량조적혈청전백단백수평사용면역비탁법.결과 관찰조적전백단백수평유현저하강,[(0.21±0.07) g/L vs (0.30±0.05) g/L, P<0.05];대조조여관찰조적전백단백수평정상솔유명현차이(100.0% vs 29.3%, P<0.05);단지、2지화3 지관맥수루적환자,기전백단백수평축점하강[(0.25±0.06) g/L vs (0.21±0.06) g/L vs (0.18±0.05) g/L, P<0.05];근거Spearman상관분석,관맥병변적엄중정도여혈청전백단백수평정부상관(r=-0.233, P<0.05);미발생심혈관사건자상비발생심혈관사건자,기전백단백수평정교고수평[(0.24±0.07)g/L vs (0.18±0.06) g/L,P<0.05].결론 당급성심경발작후,환자적전백단백수평유현저적하강,차기강저적폭도여병변적엄중정도상관,가능여환자적예후유관,고가작위지표래대심경환자적병정변화진행검측화예후진행판단.
Objective To investigate the relationship between serum prealbumin level and the severity of acute myocardial infarction (AMI) so as to provide evidence for the early diagnosis and treatment of the disease. Methods 112 AMI patients visited the depart-ment from March 2011 to November 2013 were selected as the observation group. The observation group underwent coronary an-giography. The result of coronary angiography showed that 39 cases had single-vessel disease, 37 cases had double-vessel disease, 36 cases had triple-vessel disease. 42 cases had cardiovascular events and other 72 cases had not. And 50 cases underwent phys-ical examination during the same period were randomly selected as the control group. Immune turbidity method was used to test the prealbumin level of the two groups and the result of test of the two groups was compared. The prealbumin level was compared between the single-vessel disease patients, double-vessel disease patients and triple-vessel disease patients in the observation group and the relationship between the incidence of cardiovascular events and prealbumin level was investigated. Results Com-pared with the control group, the serum prealbumin level of the observation group decreased significantly, [(0.21 ±0.07) g/L vs (0.30 ±0.05) g/L], P<0.05. The difference in the normal rate of prealbumin level between the control group and the observation group was statistically significant (100.0% vs 29.3%), P<0.05. The prealbumin level decreased gradually in single-vessel disease patients, double-vessel disease patients and triple-vessel disease patients[(0.25±0.06) g/L vs (0.21±0.06) g/L vs (0.18±0.05) g/L], P<0.05. Spearman correlation analysis showed that the serum pre-albumin level was negatively related with the severity of coro-nary artery 1esions (r=-0.233, P<0.05). Compared with the patients without cardiovascular events,the patients with cardiovascular events had a significantly lower level in pre-albumin [(0.24±0.07) g/L vs (0.18±0.06) g/L], P<0.05. Conclusion The level of preal-bumin in observation group was significantly lower, and the degree of reduction might relate to the severity and prognosis of the disease. The prealbumin level can be the indicator of AMI condition monitoring and prognosis judgment.