ACA、ACE联合血清锌离子浓度对老年急性心肌梗死合并心力衰竭的诊断及预后预测

摘要/Abstract

摘要： 目的探讨抗心磷脂抗体（ACA）、血管紧张素转换酶（ACE）联合血清锌离子浓度对老年急性心肌梗死合并心力衰竭的诊断及预后预测。方法选取2020年3月—2023年3月内蒙古自治区人民医院收治的84例急性心肌梗死合并心力衰竭患者作为心力衰竭组,选取同期治疗的80例单纯急性心肌梗死未并发心力衰竭患者作为非心力衰竭组。比较两组患者ACA、ACE及血清锌离子浓度,建立受试者特征（ROC）工作曲线分析ACA、ACE联合血清锌离子对老年急性心肌梗死合并心力衰竭的诊断价值。随后将84例急性心肌梗死并发心力衰竭患者中院内死亡者分为死亡组（20例）,将其余患者分为存活组（64例）,比较两组患者临床一般情况,并分析ACA、ACE及血清锌离子浓度对急性心肌梗死合并心力衰竭预后的预测价值。结果心力衰竭组ACA、ACE水平明显高于非心力衰竭组,锌离子浓度明显低于非心力衰竭组,差异有统计学意义（P<0.05）;ACA、ACE联合血清锌离子三者联合对老年急性心肌梗死合并心力衰竭的诊断效能优于单一检测。存活组与死亡组患者性别、年龄、身体素质指数（BMI）、合并糖尿病、高血压、高脂血症、左心室射血分数、支架数、支架长度比较,差异无统计学意义（P>0.05）;存活组与死亡组患者Killip分级、合并陈旧性心肌梗死、ACA、ACE及血清锌离子浓度比较,差异有统计学意义（P<0.05）;Logistic回归分析结果表明,Killip分级、ACA、ACE及血清锌离子为急性心肌梗死合并心力衰竭预后的独立预测指标。结论 ACA、ACE联合血清锌离子浓度对急性心肌梗死合并心力衰竭诊断价值较高,且临床可考虑通过ACA、ACE及血清锌离子浓度来预测急性心肌梗死合并心力衰竭患者的预后情况。

关键词: 抗心磷脂抗体, 血管紧张素转换酶, 锌离子, 急性心肌梗死, 心力衰竭

Abstract: ： Objective To explore the diagnostic and prognostic prediction of anticardiolipin antibodies (ACA), angiotensin converting enzyme (ACE), and serum zinc ion concentration in elderly patients with acute myocardial infarction and heart failure. Methods A total of 84 patients with acute myocardial infarction combined with heart failure admitted to the People's Hospital of Inner Mongolia Autonomous Region from March 2020 to March 2023 were selected and divided into the heart failure group, and 80 patients with simple acute myocardial infarction without complicated heart failure treated in the same period were selected as the non-heart failure group. By comparing ACA, ACE, and serum zinc ion concentration, the subject characteristic (ROC) working curve was established to analyze the diagnostic value of ACA, ACE and serum zinc ion on acute myocardial infarction combined with heart failure in the elderly. Subsequently, 84 patients with acute myocardial infarction and heart failure were divided into death group (n=20), and the remaining patients were divided into survival group (n=64). The clinical general situation of the two groups was compared, and the predictive value of ACA, ACE and serum zinc ion concentration on the prognosis of acute myocardial infarction with heart failure was analyzed. Results ACA and ACE were significantly higher in the heart failure group than that in the non-heart failure group, and the zinc ion concentration was significantly lower than that in the non-heart failure group (P<0.05). The diagnostic efficacy of the combination of ACA, ACE, and serum zinc ions in elderly patients with acute myocardial infarction combined with heart failure is better than that of a single test. There was no significant difference in sex, age, BMI, diabetes, hypertension, hyperlipidemia, left ventricular ejection fraction, number of stents, and length of stents between the survival group and the death group (P>0.05). There was significant difference in Killip grade, old myocardial infarction, ACA, ACE, and serum zinc concentration between the survival group and the death group (P<0.05). The results of logistic regression analysis showed that Killip grade, ACA, ACE and serum zinc ions were independent predictors of the outcome of acute myocardial infarction with heart failure. Conclusion The combination of ACA, ACE, and serum zinc ion concentration has high diagnostic value for acute myocardial infarction with heart failure, and clinical practice can consider predicting the prognosis of patients with acute myocardial infarction with heart failure through ACA, ACE, and serum zinc ion concentration.

Key words: anticardiolipin antibodies, angiotensin converting enzyme, zinc ions, acute myocardial infarction, heart failure

中图分类号:

R541

王璐. ACA、ACE联合血清锌离子浓度对老年急性心肌梗死合并心力衰竭的诊断及预后预测[J]. 中华养生保健, 2024, 42(8): 192-196.

WANG Lu. Diagnosis and Prognostic Prediction of Acute Myocardial Infarction Combined with Heart Failure in the Elderly by ACA, ACE, and Serum Zinc Ion Concentrations[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(8): 192-196.

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