急性心肌梗死对血清补体水平及其预后影响的相关性研究

摘要

Objective To discuss the change law of level of serum complement and its influence on prognosis in patients with acute myocardial infarction (AMI).Methods AMI patients (n=108) as study group and healthy controls (n=50) as control group were chosen from the Department of Geriatrics of First People's Hospital of Xining City from Dec. 2015 to Dec. 2016. The difference in constituent of age and sex had no statistical significance between 2 groups (P>0.05). The level of serum complement was detected and compared in 2 groups, and correlation between prognosis and level of serum complement was analyzed.Results After AMI attack for 24 h,the levels of fasting plasma glucose (FPG),triglyceride (TG),total cholesterol (TC) and fibrinogen (Fg) were significantly higher,and level of high-density lipoprotein-cholesterol (HDL-C) was significantly lower in study group than those in control group (P<0.05). After AMI attack for 24 h,72 h and 1 week,the levels of serum complements C3,C4 and C5b-9 were significantly higher in study group than those in control group (P<0.05). After AMI attack for 72 h,the levels of serum complements C3,C4 and C5b-9 were positively correlated to the levels of creatine kinase-MB isoenzyme (CK-MB) and cardiac troponin T (cTnT). In AMI patients,the levels of serum complements C3,C4 and C5b-9 significantly higher in MACE group than those in non-MACE group (P<0.05) after AMI attack for 72 h. Conclusion As the level of serum complement increases,the status of AMI will be more severe and prognosis will be poorer. The detection of serum complements can provide reliable evidence for predicting short-term prognosis in AMI patients.%目的 探讨急性心肌梗死(AMI)患者血清补体水平的变化规律及其预后影响.方法 选取西宁市第一人民医院老年病科于2015年12月~2016年12月收治的108例AMI患者为研究组,另选取50例健康体检者为对照组,两组研究对象在年龄、性别构成比等方面比较,差异无统计学意义(P>0.05).检测并比较两组血清补体水平,并分析AMI患者预后与血清补体水平的相关性.结果 研究组患者发病后24 h的空腹血糖(FPG)、三酰甘油(TG)、总胆固醇(TC)、纤维蛋白原(Fg)水平均显著高于对照组,高密度脂蛋白胆固醇(HDL-C)水平显著低于对照组(P<0.05).研究组患者发病后24 h、72 h、1周时血清补体C3、C4、C5b-9的水平均显著高于对照组(P<0.05).AMI患者发病72 h的血清补体C3、C4、C5b-9与肌酸激酶同工酶(CK-MB)、肌钙蛋白T(TnT)水平均呈正相关.AMI患者中,MACE组发病72 h测血清补体C3、C4、C5b-9水平均显著高于非MACE组(P<0.05).结论 AMI患者血清补体水平越高预示病情越重、预后越差,检测血清补体水平可为临床预测患者近期预后提供可靠依据.