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Adiponectin receptor 1 and small ubiquitin-like modifier 4 polymorphisms are associated with risk of coronary artery disease without diabetes

ISSN号：1672-4860
期刊名称：《中国老年保健医学》
时间：0
分类：R654.2[医药卫生—临床医学;医药卫生—外科学]
作者机构：首都医科大学附属北京安贞医院急诊危重症中心,北京100029
相关基金：国家自然科学基金面上项目（81570323）; 首都医科大学高校科技创新服务能力建设（PXM2017_014226_000037）

作者： Hong LI[1], Ze YANG[2], Lian-Mei PU[1], Xiang LI[1], Yang RUAN[1], Fan YANG[3], Shuai MENG[1], Duo YANG[1], Wei YAO[1], Hao FU[1], Feng ZHANG[1], Ze-Ning JIN[1]

关键词：主动脉内球囊反搏, 急性冠状动脉综合征, 心源性休克, 血流动力学, Intra-aortic balloon pump, Acute coronary syndrome, Cardiogenic shock, Hemodynamic

中文摘要：

目的分析接受主动脉内球囊反搏（IABP）辅助行经皮冠状动脉介入治疗（PCI）急性冠状动脉综合征（ACS）合并心源性休克患者的特征及预后情况。方法回顾性分析北京安贞医院2014年1月至2015年12月应用IABP辅助行PCI的ACS合并心源性休克患者197例,根据患者生存情况分为存活组（162例）和死亡组（35例）,比较两组患者的临床特点及住院不良事件的发生情况。结果 197例患者平均年龄（57.3±14.7）岁,入院时平均动脉压（53.3±14.6）mmHg（1 mmHg=0.133 kPa）。两组患者入院时性别、吸烟、高血压病、高脂血症、肌酸激酶同工酶（CK-MB）、血肌酸酐比较,差异均无统计学意义（均P〉0.05）;而存活组患者年龄、2型糖尿病、陈旧性心肌梗死、心肌肌钙蛋白I（cTnI）水平显著低于死亡组（均P〈0.05）。IABP置入前后,存活组患者收缩压、舒张压、平均动脉压、心脏指数的升高水平显著大于死亡组,差异均有统计学意义（均P〈0.05）;而两组患者心率、动脉血氧饱和度的升高值比较,差异均无统计学意义（均P〉0.05）。两组患者罪犯血管在左前降支、左回旋支、右冠状动脉,完全血管化,TIMI血流Ⅲ级,症状发作-球囊扩张时间,进门-球囊扩张时间比较,差异均无统计学意义（均P〉0.05）;存活组患者罪犯血管在左主干比例、术后24 h CK-MB值、术后24 h cTnI值显著小于死亡组,差异均有统计学意义（均P〈0.05）;而ST段回落〉50%比例显著大于死亡组患者,差异亦有统计学意义（P〈0.05）。存活组患者再发心肌梗死、急性肾损伤、床旁血滤、有创机械通气发生率及住院时间显著低于死亡组患者,差异均有统计学意义（均P〈0.05）;而两组患者血管活性药使用率比较,差异无统计学意义（P〉0.05）。结论 ACS合并心源性休克患者进行IABP辅助PCI存在较高的不良事件发生风险。死亡组患者表现为高龄、合?

英文摘要：

Objective To analyze the characteristics and prognosis of intra-aortic balloown pump （IABP） supported percutaneous coronary intervention （PCI） in patients with Acute Coronary Syndrome （ACS） complicated with cardiogenic shock （CS）.Methods 197 ACS patients complicated with CS patients received IABP supported PCI in Beijing Anzhen hospital from January 2014 to December 2015 were involved.According to the clinical results, all patients were divided into survival group and non-survival group.The clinical and laboratory parameters were compared between groups.Results Among the 197 patients enrolled, there were 162 patients in the survival group and 35 patients in the non-survival group.The mean age was （57.3＆#177;14.7） year-old, mean arterial blood pressure （MAP） on admission was （53.3＆#177;14.6） mmHg （1 mmHg=0.133 kPa）.Percentage of diabetes comorbidity, cTnI level, oxygen index and MAP were significantly different between the survival and the non-survival groups （P〈0.05）.The symptom onset to balloon time and door-to-balloon time intervals were found delayed with significant difference in the non-survival group compared to the survival group （P〈0.05）.IABP improved hemodynamic parameters including blood pressure, cardiac function and oxygen index （P〈0.05） in both groups.Duration of vasopressor usage, IABP implantation, percentage of invasive mechanical ventilation, length of stay in intensive care unit, acute kidney injury （AKI） and re-infarction were also significantly different between the two groups （P〈0.05）.Conclusions Adverse events risk is higher in ACS patients complicated with cordiogenic shock requiring IABP support for PCI.Patients with mortal outcomes are older, comorbid with diabetes mellitus and history of myocardial infarction and higher event rates of re-infarction and acute kidney injury during hospitalization.Intensive care should be implemented to reduce the incidence of adverse events.

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