急性冠脉综合征患者血清铁含量与心功能水平、心肌损伤程度的相关性

摘要

Objective To study the correlation between serum iron level and cardiac function level,myocardial injury degree in patients with acute coronary syndrome (ACS).Methods ACS patients treated in Changqing People's Hospital of Ji'nan City from January 2015 to December 2016 were selected and divided into unstable angina pectoris (UAP) group (30 cases),non ST segment elevation myocardial infarction (USTEMI) group (25 cases),ST segment elevation myocardial infarction (STEMI) group (35 cases) according to disease condition.The patients with stable angina (SAP) and healthy volunteers during the same period were selected as SAP group (45 cases) and control group (50 cases).Serum was collected and the contents of iron,myocardial injury indexes and oxidative stress indexes were measured,and the cardiac function parameters were measured by color Doppler ultrasound.Results The contents of cardiac ultrasound parameters endsystolic volume index (ESVI),end diastole volume indication (EDVI) and serum creatine kinase isoenzyme (CK-MB),troponin Ⅰ (cTnI),myohemoglobin (Myo),malonaldehyde (MDA),advanced oxidation protein products (AOPP) of UAP group,USTEMI group,STEMI group were significantly higher than those of SAP group and control group (P ＜ 0.05),the cardiac ultrasound parameters left ventricular ejection fraction (LVEF) and contents of serum superoxide dismutase (SOD),catalase (CAT) were significantly lower than those of SAP group and control group (P ＜ 0.05);the more severe the ACS disease condition,the higher the cardiac ultrasound parameters ESVI,EDVI and serum CK-MB,cTnI,Myo,MDA,AOPP contents (P ＜ 0.05),the lower the cardiac ultrasound parameters LVEF and serum SOD,CAT contents (P ＜ 0.05).The serum iron levels were negatively correlated with cardiac ultrasound parameters ESVI,EDVI and serum CK-MB,cTnI,Myo,MDA,AOPP contents (P ＜ 0.05),which were positively correlated with cardiac ultrasound parameters LVEF and serum SOD,CAT contents (P ＜ 0.05).Conclusion The serum iron levels in ACS patients are significantly decreased,which may be correlated with cardiac function and myocardial oxidative stress degree.%目的 研究急性冠脉综合征(ACS)患者血清铁含量与心功能水平、心肌损伤程度的相关性.方法 选择2015年1月～2016年12月在济南市长清区人民医院就诊的ACS患者,并根据病情分为不稳定型心绞痛(UAP)组(30例)、非ST段抬高型心肌梗死(USTEMI)组(25例)、ST段抬高型心肌梗死(STEMI)组(35例),选择同期就诊的稳定型心绞痛(SAP)患者和体检的健康志愿者分别作为SAP组(45例)和对照组(50例).采集血清并测定铁、心肌损伤指标、氧化应激指标的含量,行彩色多普勒超声测定心功能参数.结果 UAP组、USTEMI组、STEMI组患者的心功能超声参数收缩末期容量指数(ESVI)、舒张末期容量指数(EDVI)以及血清中肌酸激酶同工酶(CK-MB)、肌钙蛋白Ⅰ(cTnI)、肌红蛋白(Myo)、丙二醛(MDA)、蛋白晚期氧化产物(AOPP)的含量均显著高于SAP组、对照组(P＜0.05),心功能超声参数左心室射血分数(LVEF)以及血清中超氧化物歧化酶(SOD)、过氧化氢酶(CAT)的含量均显著低于SAP组、对照组(P＜0.05),ACS的病情越重,心功能超声参数ESVI、EDVI以及血清中CK-MB、cTnI、Myo、MDA、AOPP的含量越高(P＜0.05),心功能超声参数LVEF以及血清中SOD、CAT的含量越低(P＜0.05);血清铁含量与心功能超声参数ESVI、EDVI以及血清中CK-MB、cTnI、Myo、MDA、AOPP的含量呈负相关(P＜0.05),与心功能超声参数LVEF以及血清中SOD、CAT的含量呈正相关(P＜0.05).结论 ACS患者血清铁含量显著降低,可能与心功能水平降低、心肌氧化应激损伤程度加剧有关.