急性心肌梗死患者白蛋白水平的变化及其意义的临床研究被引量：21

Serum albumin in patients with acute myocardial infarction and its effect on in-hospital prognosis

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摘要目的研究急性心肌梗死(AMI)患者血清白蛋白水平的改变及与高敏C!反应蛋白(Hs!CRP)的关系,并探讨其对急性心肌梗死患者预后的影响。方法总结82例AMI患者入院时血清白蛋白、Hs!CRP水平,并分析超声心动图所测左室射血分数,评价住院期间预后情况;选择50例非冠心病老年患者血清白蛋白水平作为对照。结果AMI组总体血清白蛋白水平低于对照组(P<0.001)。根据血清白蛋白水平,将AMI患者分为低血清白蛋白组及正常血清白蛋白组。低血清白蛋白组年龄偏大,女性患者较多(P<0.05);同时,Hs!CRP水平(8.76mg/L)显著高于正常血清白蛋白组的4.71mg/L(P<0.001),左室射血分数〔(49.71±9.71)%〕低于正常血清白蛋白组的(56.43±9.85)%(P<0.05),住院期间死亡6例(33.33%),显著高于正常血清白蛋白组的4例(6.25%)(P<0.01)。多元相关分析显示,白蛋白与年龄、Hs!CRP、死亡呈负相关(P<0.05)。Logistic回归分析显示,死亡与血清白蛋白具有很好的相关性(回归系数为!1.709,wald值为4.169,P=0.041)。结论急性心肌梗死患者的血清白蛋白水平与临床预后相关,低白蛋白血症可作为患者预后的一个重要预测因子。 Objective To study the change of serum albumin in patients with acute myocardial infarction （AMI） and its relation with high-sensitivity CRP（Hs-CRP）, and evaluate whether hypoalbuminemia on admission is a predictor for adverse outcomes in AMI patients. Methods Serum albumin and Hs-CRP on admission were analysied in 82 AMI patients and 50 controls LV function on echocardiography and mortality were assessed. Results serum albumin in AMi patients was （38.45±4.76）g/L, lower than that in control （P〈0.001）. All AMI patients were divided into 2 groups based on the values of serum albumin： hypoalbuminemia group and normal albuminemia group. Patients in the hypoalbuminemia group were older, had more female cass （P〈0.05）, higher serum Hs-CRP （P〈0.01） and lower left ventricular ejection fraction （LVEF）（P〈0.05） than those in the normal albuminemia group. Mortality was higher in hypoalbuminemia group （P〈0.01）. Bivaxiable correlation analysis revealed that there was a negative correlation between serum albumin and age, Hs-CRP, mortality （P〈0.05）. Logistics regression analysis showed that hypoalbuminemia was the risk factor for in-hospital mortality of AMI patients （regression coefficient was 0.213,wald value was 4.096, P=0.043）. Conclusions Low serum albumin in patients with AMI may be an important predictor of adverse outcome.

作者邓次妮沈潞华

机构地区首都医科大学附属北京友谊医院心血管中心

出处《北京医学》 CAS 2006年第6期331-333,共3页 Beijing Medical Journal

关键词急性心肌梗死血清白蛋白高敏C-反应蛋白左室射血分数 Acute myocardial infarction （AMI） Serum albumin High-sensitivity CRP （Hs-CRP） Left ventricular ejection fraction

分类号 R542.22 [医药卫生—心血管疾病] R473.5 [医药卫生—护理学]

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