论文部分内容阅读
目的评估游离脂肪酸与急性冠状动脉综合征(ACS)严重程度的关系。方法前瞻性分析2014年7月-2015年5月收治的93例ACS患者的资料,其中急性ST抬高心肌梗死(STEMI)35例,急性非ST抬高心肌梗死(NSTEMI)34例,不稳定型心绞痛(UA)24例;将同期入院,且排除冠状动脉粥样硬化性心脏病、心力衰竭,心电图、心肌损伤标志物正常的29例患者作为对照组。对其入院后24 h内的血游离脂肪酸进行统计分析。结果 ACS组和对照组游离脂肪酸分别为(1.08±0.41)、(0.51±0.15)mmol/L,差异有统计学意义(P<0.05);ACS组中STEMI、NSTEMI、UA患者的游离脂肪酸分别为(1.32±0.38)、(1.12±0.35)、(0.67±0.10)mmol/L,STEMI、NSTEMI患者的游离脂肪酸高于UA患者,差异有统计学意义(P<0.05);STEMI、NSTEMI患者间游离脂肪酸比较差异无统计学意义(P>0.05)。NSTEMI、UA患者共58例采用Grace风险评分,其中Grace评分≥140分者30例,游离脂肪酸为(1.12±0.37)mmol/L;Grace评分<140分者28例,游离脂肪酸为(0.73±0.17)mmol/L,二者比较差异有统计学意义(P<0.05)。35例STEMI患者采用Killip分级,其中KillipⅠ~Ⅱ级16例,游离脂肪酸为(1.17±0.37)mmol/L;KillipⅢ~Ⅳ级19例,游离脂肪酸为(1.45±0.35)mmol/L,二者比较差异有统计学意义(P<0.05)。结论 ACS发生时,游离脂肪酸升高与ACS发生缺血的风险及严重程度明显相关。
Objective To evaluate the relationship between free fatty acids and the severity of acute coronary syndrome (ACS). Methods A prospective analysis of 93 ACS patients admitted from July 2014 to May 2015 was conducted. Among them, 35 cases were acute ST-elevation myocardial infarction (STEMI), 34 cases were acute non-ST-elevation myocardial infarction (NSTEMI) and unstable Angina pectoris (UA) in 24 cases. 29 cases with normal coronary heart disease, heart failure, electrocardiogram and myocardial injury were enrolled in the same period and served as the control group. Statistical analysis of blood free fatty acids within 24 h after admission was performed. Results The free fatty acids in ACS group and control group were (1.08 ± 0.41) and (0.51 ± 0.15) mmol / L, respectively (P <0.05). The levels of free fatty acids in STEMI, NSTEMI and UA patients in ACS group were (1.32 ± 0.38), (1.12 ± 0.35) and (0.67 ± 0.10) mmol / L, respectively. There was a statistically significant difference between the two groups in STEMI and NSTEMI (P <0.05) There was no significant difference in fatty acid (P> 0.05). Among the 58 patients with NSTEMI and UA, Grace risk score was used in 58 patients. Among them, 30 patients with Grace score≥140, (1.12 ± 0.37) mmol / L free fatty acid, 28 patients with Grace score <140 and 0.73 ± 0.17 ) mmol / L, the difference was statistically significant (P <0.05). Thirty-five STEMI patients were treated with Killip grading, including 16 cases of Killip Ⅰ-Ⅱ grade, 1.17 ± 0.37 mmol / L of free fatty acid, 19 cases of Killip Ⅲ-Ⅳ grade, and 1.45 ± 0.35 mmol / L of free fatty acid The difference was statistically significant (P <0.05). Conclusions When ACS occurs, the increase of free fatty acid is significantly associated with the risk and severity of ischemia in ACS.