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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

29卷

期数:

2023年02期

页码:

109-112

栏目:

心血管疾病专题

出版日期:

2023-03-20

文章信息/Info

Title:

Relationship between initial serum anion gap and in-hospital mortality in patients with acute ST-segment elevation myocardial infarction

文章编号:

1006-8147（2023）02-0109-04

作者:

赵晓彬¹; 牛书林²; 邱久纯³; 余淑华¹; 袁如玉³

1.郑州大学附属郑州中心医院高血压科，郑州450007;2.天津医科大学总医院心血管内科，天津300052;3.天津医科大学第二医院心脏科，天津300211

Author(s):

ZHAO Xiao-bin¹; NIU Shu-lin²; QIU Jiu-chun³; YU Shu-hua¹; YUAN Ru-yu³

1.Department of hypertension，Zhengzhou Central Hospital Affiliated to Zhengzhou University，Zhengzhou 450007，China;2.Department of cardiovascular Medicine，General Hospital，Tianjin Medical University，Tianjin 300052，China;3.Department of cardiology，The Second Hospital，Tianjin Medical University，Tianjin 300211，China

关键词:

急性ST段抬高型心肌梗死; 阴离子间隙; 心力衰竭; 院内死亡率

Keywords:

acute ST-segment elevation myocardial infarction;  anion gap;  heart failure;  in-hospital mortality rate

分类号:

R541.4

DOI:

-

文献标志码:

A

摘要:

目的：探讨急性ST段抬高型心肌梗死（STEMI）早期阴离子间隙（AG）与院内死亡率的关系。方法：回顾性研究459例STEMI患者，分为AG升高组（AG≥16mmol/L，n=230）和AG正常组（AG＜16mmol/L，n=229），对N端脑利钠肽前体（NT-proBNP）、肌钙蛋白I（TnI）、估算的肾小球滤过率（eGFR）和射血分数（EF）等进行分析；以院内是否发生死亡为因变量，进行Logistic回归分析，比较AG与年龄、性别、eGFR和EF的相关性。结果：两组性别、高血压、糖尿病、血脂异常、吸烟、家族史等差异均无统计学意义（均P＞0.05）。与AG正常组相比，AG升高组的NT-proBNP和TnI升高（均P＜0.05），eGFR和EF降低（均P＜0.05），院内心力衰竭和死亡的发生率显著升高（均P＜0.05）。Logisitic回归分析发现AG升高是STEMI患者早期院内死亡的独立危险因素（OR=1.179，95%CI：1.034～1.345，P=0.014）。结论：AG升高可增加STEMI患者院内心力衰竭和死亡风险，是STEMI早期评估预后的独立危险因素。

Abstract:

Objective：To investigate the relationship between early anion gap（AG）level and in-hospital mortality in patients with acute ST-segment elevation myocardial infarction（STEMI）. Methods：A retrospective study was conducted on 459 patients with STEMI. The patients were divided into two groups：elevated AG group（AG≥16 mmol/L，n=230）and normal group（AG<16 mmol/L， n=229）. N-telencephalic natriuretic peptide precursor（NT-ProBNP），Troponin I（TnI），estimated glomerular filtration rate（eGFR）and ejection fraction （EF）were analyzed between two groups. With in-hospital death as the dependent variable，Logistic regression analysis was performed to compare the correlation between AG and age，sex，eGFR and EF. Results：There was no significant difference in gender， smoking status，family history and other factors between two groups，as well as incidence of hypertension，diabetes and dyslipidemia（all P>0.05）. Compared with normal group，NT-proBNP and TnI in elevated AG group were significantly increased（all P<0.05），eGFR and EF were significantly decreased（all P<0.05），the incidence of heart failure and in-hosptial mortality was significantly increased（all P<0.05）. Logisitic regression analysis showed that elevated AG was an independent risk factor for early in-hospital death in STEMI patients （OR=1.179，95%CI：1.034-1.345，P=0.014）. Conclusion：Elevated AG increases the risk of in-hospital heart failure and death in STEMI patients，which is an independent risk factor for early prognosis assessment of STEMI.

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相似文献/References:

[1]崔利军,马向红,段雯婷,等.SYNTAX积分与急性心肌梗死急诊介入治疗后心血管事件的关系[J].天津医科大学学报,2015,21(03):43.
　CUI Li-jun,MA Xiang-hong,DUAN Wen-ting,et al.SYNTAX score and cardiovascular events in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention[J].Journal of Tianjin Medical University,2015,21(02):43.
[2]崔利军,马向红,段雯婷,等.SYNTAX积分与急性心肌梗死急诊介入治疗后心血管事件的关系[J].天津医科大学学报,2015,21(01):43.
　CUI Li-jun,MA Xiang-hong,DUAN Wen-ting,et al.SYNTAX score and cardiovascular events in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention[J].Journal of Tianjin Medical University,2015,21(02):43.
[3]刘 杰,宋书凯.早期应用不同剂量替罗非班在急性ST段抬高型心肌梗死患者中的临床观察[J].天津医科大学学报,2017,23(01):59.
　LIU Jie,SONG Shu-kai.Clinical observation of early application of different doses of trofiban in patients with acute ST-segment elevation myocardial infarction[J].Journal of Tianjin Medical University,2017,23(02):59.
[4]赵晓彬,牛书林,袁如玉.关于急性心肌梗死早期阴离子间隙的研究[J].天津医科大学学报,2020,26(04):333.
　ZHAO Xiao-bin,NIU Shu-lin,YUAN Ru-yu.Association between initial anion gap and acute myocardial infarction[J].Journal of Tianjin Medical University,2020,26(02):333.

备注/Memo

备注/Memo:

基金项目：天津市自然科学基金（19JCYBJC26800）
作者简介：赵晓彬（1983-），男，主治医师，硕士，研究方向：心血管疾病的基础与临床研究；
通信作者：袁如玉，E-mail：yuanruyu2014@126.com。

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更新日期/Last Update: 2023-04-30