血浆醛固酮水平对急性冠脉综合征患者冠脉病变及预后的预测价值

摘要

Objective:To investigate the influence of serum aldosterone levels to the severity of coronary artery lesions and the recent prognosis in acute coronary syndrome(ACS)patients underwent percutaneous coronary intervention(PCI).Method:The study included 166 ACS patients admitted in author’s department of cardiology from January 2010 to January 2011.All the patients received coronary angiography and were divided into three groups according to aldosterone levels:A group(Aldo<100 ng/ml); B group(100 ng/ml ≤ Aldo ≤ 200 ng/ml); C group(Aldo>200 ng/ml). Serum aldosterone level was measured and analyzed its relationship with the severity of coronary artery lesions and the recent prognosis of ACS patients underwent PCI.Result:ACS Patients in group with higher Aldo levels had higher incidence rates of multi-vessel lesions,B2/C type lesions and higher Gensini accumulated points; ⑵ Multivariaste Logistic regression analyis indicated that serum aldosterone was a srtong independent predictor for incidence rate of major adverse cardiac events(MACE)in ACS patients underwent PCI within 6 months.Conclusion:The serum aldosterone level is associated with the severity of coronary artery lesions in ACS patients.Aldoterone level is valuable in predicting the recent prognosis of ACS patients underwent PCI.%　　目的：探讨急性冠脉综合征(ACS)患者血浆醛固酮(Aldo)水平对冠状动脉病变严重程度的影响及与患者近期预后的关系.方法：选择2010年1月-2011年1月在本院心内科住院并行冠脉造影检查的 ACS 患者166例,冠脉造影检查前于升主动脉根部采取血标本,测定醛固酮水平,按醛固酮水平高低分为三组：A 组(Aldo<100 ng/ml),B 组(100 ng/ml ≤ Aldo ≤200 ng/ml)及 C 组(Aldo>200 ng/ml).根据冠脉造影结果,分析各组 ACS 患者醛固酮水平与冠脉病变严重程度的关系；并观察 ACS 患者经皮腔冠脉内介入治疗(PCI)术前醛固酮水平对术后近期预后(6个月)的影响.结果：三组 ACS 患者随 Aldo 水平升高,多支血管病变、冠脉 B2/C 型病变、冠脉病变狭窄程度积分(Gensini积分)均明显增高,组间差异有统计学意义(P<0.05或 P<0.01)；多因素 Logistic 回归分析显示醛固酮是 ACS 患者 PCI 术后6个月内 MACE发生的独立预测因子.结论：ACS 患者血浆醛固酮水平与冠脉病变严重程度相关,醛固酮水平的高低对 ACS 患者 PCI 术后的近期预后有预测价值.