|本期目录/Table of Contents|

[1]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):333-336.
 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(04):333-336.
点击复制

关于急性心肌梗死早期阴离子间隙的研究(PDF)
分享到:

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

卷:
26卷
期数:
2020年04期
页码:
333-336
栏目:
临床医学
出版日期:
2020-07-15

文章信息/Info

Title:
Association between initial anion gap and acute myocardial infarction
文章编号:
1006-8147(2020)04-0333-04
作者:
赵晓彬牛书林袁如玉
(天津医科大学第二医院心脏科,天津市心血管病离子与分子机能重点实验室,天津心脏病学研究所,天津 300211)
Author(s):
ZHAO Xiao-bin NIU Shu-lin YUAN Ru-yu
(Department of Cardiology, The Second Hospital, Tianjin Medical University, Tianjin Key Laboratory of Ionic -Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, Tianjin 300211, China)
关键词:
急性心肌梗死阴离子间隙心力衰竭
Keywords:
acute myocardial infarction anion gap heart failure
分类号:
R541.4
DOI:
-
文献标志码:
A
摘要:
目的:探讨急性心肌梗死(AMI)与阴离子间隙(AG)的关系。方法:对352例AMI患者和268例不稳定型心绞痛(UA)患者进行回顾性分析。比较两组初始AG的差异;将AMI组按左室射血分数(LVEF)水平分为射血分数减低的心力衰竭(HFrEF),射血分数中间值的心力衰竭(HFmrEF)和射血分数保留的心力衰竭(HFpEF)3个亚组,观察AG与AMI患者院内心力衰竭程度的关系。结果:与UA组相比,AMI组AG明显升高(P<0.001),二氧化碳结合力(CO2CP)明显降低(P<0.001)。AMI亚组分析发现初始AG水平与院内心力衰竭程度呈正相关,组间比较均有统计学差异(P<0.05)。Logistic回归分析表明,AMI院内心力衰竭程度与初始AG水平有关(OR=1.156,P=0.004,95%CI:1.047~1.275)。结论:初始AG水平可作为AMI的临床状态和危重度的评估,也是AMI患者发生心功能损害轻重的独立预测因子。
Abstract:
Objective: To investigate the relationship between acute myocardial infarction(AMI) and anion gap (AG). Methods: 352 patients with AMI and 268 patients with unstable angina (UA) were retrospectively analyzed. The difference of initial anion gap (AG) between the two groups was compared. The AMI group was divided into three subgroups according to the level of LVEF: HFrEF, HFmrEF and HFpEF. The relationship between AG and the degree of in-hospital heart failure in AMI patients was observed. Results: Compared with UA group, AG in AMI group was significantly increased (P<0.001), while CO2CP was decreased (P<0.001). AMI subgroup analysis showed that initial AG was positively correlated with the degree of in-hospital heart failure, and there were statistical differences between groups (P<0.05). Logistic regression analysis showed that the degree of in-hospital heart failure in AMI patients was related to initial AG(OR=1.156, P=0.004,95%CI:1.047-1.275). Conclusion: The initial AG level can be used as an assessment of the clinical status and severity of AMI,and is also an independent predictor of the severity of cardiac impairment in AMI patients.

参考文献/References:

[1] Reed G W, Rossi J E, Cannon C P. Acute myocardial infarction[J]. Lancet, 2017, 389(10065):197
[2] He H, Wang S, Li X, et al. A novel metabolic balance model for describing the metabolic disruption of and interactions between cardiovascular-related markers during acute myocardial infarction[J]. Metabolism, 2013, 62(10):1357
[3] Thygesen K, Alpert J S, Jaffe A S, et al. Fourth universal definition of myocardial infarction (2018)[J]. Eur Heart J, 2019, 40(3):237
[4] Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology(ESC)[J]. Eur Heart J, 2018, 39(2):119
[5] Roffi M, Patrono C, Collet J P, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: task force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology(ESC)[J]. Eur Heart J, 2016, 37(3):267
[6] 上海慢性肾脏病早发现及规范化诊治与示范项目专家组, 高翔, 梅长林. 慢性肾脏病筛查诊断及防治指南[J]. 中国实用内科杂志, 2017, 37(1):28
[7] Ma Y C, Zuo L, Chen J H, et al. Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease[J]. J Am Soc Nephrol, 2006, 17(10):2937
[8] 中华医学会心血管病学分会心力衰竭学组, 中国医师协会心力衰竭专业委员会, 中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018[J]. 中华心力衰竭和心肌病杂志(中英文), 2018, 2(4):196
[9] Lazzeri C, Valente S, Chiostri M, et al. Acid-base imbalance in uncomplicated ST-elevation myocardial infarction: the clinical role of tissue acidosis[J]. Intern Emerg Med, 2010, 5(1):61
[10] Kraut J A, Nagami G T. The serum anion gap in the evaluation of acid-base disorders: what are its limitations and can its effectiveness be improved?[J]. Clin J Am Soc Nephrol, 2013, 8(11):2018
[11] Kraut J A, Madias N E. Serum anion gap: its uses and limitations in clinical medicine[J]. Clin J Am Soc Nephrol, 2007, 2(1):162
[12] Ishihara K, Szerlip H M. Anion gap acidosis[J]. Semin Nephrol, 1998, 18(1):83
[13] Fidkowski C, Helstrom J. Diagnosing metabolic acidosis in the critically ill: bridging the anion gap, Stewart, and base excess methods[J]. Can J Anaesth, 2009, 56(3):247
[14] Lazzeri C, Valente S, Chiostri M, et al. Evaluation of acid-base balance in ST-elevation myocardial infarction in the early phase: a prognostic tool?[J]. Coron Artery Dis, 2010,21(5):266
[15] Sahu A, Cooper H A, Panza J A. The initial anion gap is a predictor of mortality in acute myocardial infarction[J]. Coron Artery Dis, 2006,17(5):409
[16] Reddy P, Mooradian A D. Clinical utility of anion gap in deciphering acid-base disorders[J]. Int J Clin Pract, 2009, 63(10):1516
[17] Morris C G, Low J. Metabolic acidosis in the critically ill: part 1. Classification and pathophysiology[J]. Anaesthesia, 2008, 63(3):294
[18] Wigger O, Bloechlinger S, Berger D, et al. Baseline serum bicarbonate levels independently predict short-term mortality in critically ill patients with ischaemic cardiogenic shock[J]. Eur Heart J Acute Cardiovasc Care, 2018, 7(1):45
[19] Hagiwara S, Oshima K, Furukawa K, et al. The significance of albumin corrected anion gap in patients with cardiopulmonary arrest[J]. Ann Thorac Cardiovasc Surg, 2013, 19(4):283
[20] Shiyovich A, Bental T, Assali A, et al. Changes over time in serum albumin levels predict outcomes following percutaneous coronary intervention[J]. J Cardiol, 2020, 75(4):381
[21] Plakht Y, Gilutz H, Shiyovich A. Decreased admission serum albumin level is an independent predictor of long-term mortality in hospital survivors of acute myocardial infarction. Soroka Acute Myocardial Infarction II (SAMI-II) project[J]. Int J Cardiol, 2016, 219:20
[22] Yang L J, Feng Y X, Li T, et al. Serum albumin levels might be an adverse predictor of long term mortality in patients with acute myocardial infarction[J]. Int J Cardiol, 2016, 223:647
[23] Shiyovich A, Plakht Y, Gilutz H. Serum calcium levels independently predict in-hospital mortality in patients with acute myocardial infarction[J]. Nutr Metab Cardiovasc Dis, 2018, 28(5):510
[24] Cavender M A, Steg P G, Smith S J, et al. Impact of diabetes mellitus on hospitalization for heart failure, cardiovascular events, and death: outcomes at 4 years from the reduction of atherothrombosis for continued health (REACH) registry[J]. Circulation, 2015, 132(10):923

相似文献/References:

[1]牛书林,赵晓彬,李艳芳,等.超敏C反应蛋白与急性心肌梗死患者肾功能损伤的相关性研究[J].天津医科大学学报,2020,26(04):337.
 NIU Shu-lin,ZHAO Xiao-bing,LI Yan-fang,et al.Association between high-sensitivity C-reactive protein and renal dysfunction in patients with acute myocardial infarction[J].Journal of Tianjin Medical University,2020,26(04):337.
[2]张昊,李广平,陈康寅.重组人B型脑利钠肽对急性心肌梗死患者急诊经皮冠状动脉介入治疗后对比剂肾病的预防作用[J].天津医科大学学报,2020,26(04):340.
 ZHANG Hao,LI Guang-ping,CHEN Kang-yin.Effect of recombinant human B-type natriuretic peptide in preventing contrast-induced nephropathy in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction[J].Journal of Tianjin Medical University,2020,26(04):340.
[3]赵晓彬,牛书林,邱久纯,等.初始血清阴离子间隙与急性ST段抬高型心肌梗死院内死亡的关系研究[J].天津医科大学学报,2023,29(02):109.
 ZHAO Xiao-bin,NIU Shu-lin,QIU Jiu-chun,et al.Relationship between initial serum anion gap and in-hospital mortality in patients with acute ST-segment elevation myocardial infarction[J].Journal of Tianjin Medical University,2023,29(04):109.

备注/Memo

备注/Memo:
基金项目 国家自然科学基金重点国际(地区)合作与交流项目(814100 1204)
作者简介 赵晓彬(1983-),男,主治医师,硕士在读,研究方向:心血管疾病的基础与临床;
通信作者:袁如玉,E-mail:yuanruyu2014@ 126.com。
更新日期/Last Update: 2020-07-15