Correlation among the level of serum lipid droplet protein 5 expression, coronary artery disease and short-term and ong-term efficacy in elderly patients with STEMI
-
摘要: 目的:探讨血清脂滴蛋白-5(perilipin-5)在急性ST段抬高型心肌梗死病变(STEMI)的预后价值。方法:选取2015年1月-2018年1月于我院治疗的120例STEMI老年患者作为研究对象,根据患者入院后次晨空腹血清perilipin-5检测水平中位值将STEMI老年患者分成低表达组(60例)和高表达组(60例)。比较2组患者冠状动脉病变情况、随访1年内病死率及主要心血管不良事件(MACE)发生率。结果:1年内死亡患者血清perilipin-5表达水平显著低于存活患者(P<0.001);与高表达组患者比较,低表达组患者的BMI、TG、TC表达水平偏高,HDL-C表达水平偏低,发病至入院时间更长,Killip心功能分级较高(P<0.05,P<0.001);Cox比例风险模型分析结果显示Killip心功能分级(OR=3.323,95%CI:1.370~8.060)、perilipin-5水平(OR=2.408,95%CI:1 376~4.880)、HDL-C水平(OR=2.773,95%CI:1.640~4.689)是影响STEMI老年患者预后的独立危险因素;2组患者接受PCI术比例以及PCI手术类型比较差异无统计学意义(P>0.05),但低表达组患者发生3支血管病变比例明显高于高表达组(P<0.05),且低表达组患者发病后1周、1个月、半年及1年病死率均显著高于高表达组(P<0.05),住院期间心力衰竭发生率显著高于高表达组(26.67%∶11.67%,P<0.05),另外低表达组STEMI老年患者发病后1周、1个月、半年及1年的MACE发生率显著高于高表达组(P<0.05)。结论:血清perilipin-5水平与STEMI老年患者冠状动脉病变程度和近远期预后存在显著相关性,且低perilipin-5水平是STEMI老年患者预后的独立危险因素。Abstract: Objective:o investigate the relationship among the level of serum lipid droplet protein 5(perilipin-5), coronary artery disease and the short-term and long-term effects in elderly patients with acute ST-segment elevation myocardial infarction(STEMI). Method:A total of 120 STEMI elderly patients who were treated in our hospital from January 2015 to January 2018 were selected as research subjects.According to the median level of fasting serum perilipin-5 in the morning after admission,patients with STEMI were divided into 60 cases of low expression group and 60 cases of high expression group each.Coronary artery disease,mortality and major cardiac adverse events between the two groups were compared.Result:The level of serum perilipin-5 in patients who died within one year was significantly lower than that in surviving patients(P<0.001);Compared with patients in the low-expression group, patients in the high-expression group showed higher BMI, TG, and TC expression levels, but lower HDL-C expression levels and longer time from onset to admission(P<0.05,P<0.001).Analysis of Cox proportional hazard model showed that Killip cardiac function classification(OR=3.323,95%CI=1.370~8.060),perilipin-5 level(OR=2.408,95%CI:1 376~4.880),HDL-C level(OR=2.773,95%CI:1.640~4.689) are independent risk factors affecting the prognosis of STEMI elderly patients. There was no significant difference in the proportion of patients receiving PCI and the type of PCI operation between the two groups(P>0.05),but the proportion of patients with three vascular lesions in the low-expression group was significantly higher than that in the high-expression group(P<0.05).The mortality rate at 1 week, 1 month, half a year and 1 year after the onset in the low-expression group was significantly higher than that in the high-expression group(P<0.05).he incidence of heart failure during hospitalization in the low-expression group was significantly higher than that in the high-expression group(26.67% :11.67%, P<0.05). Besides, the incidence of STEMI, the incidence of major cardiovascular adverse events(MACE) in the following 1 week, 1 month, half a year, and 1 year in the low-expression group were significantly higher than those in the high-expression group(P<0.05).Conclusion:There is a significant correlation among serum perilipin-5 levels, the degree of coronary artery disease and short-term and long-term prognosis in patients with STEMI,and low levels of perilipin-5 is an independent risk factor for prognosis in patients with STEMI.
-
Key words:
- perilipin-5 /
- acute ST segment elevation /
- myocardial infarction /
- prognosis /
- correlation
-
-
[1] Anderson JL,Morrow DA.Acute Myocardial Infarction[J].N Engl J Med,2017,376(21):2053-2064.
[2] 郝洪婷,马萍,徐清斌.宁夏地区急性ST段抬高型心肌梗死5年诊疗情况及变化趋势[J].临床心血管病杂志,2018,34(5):464-467.
[3] Chi MS,Chan LY.Thrombolytic Therapy in Acute Ischemic Stroke in Patients Not Fulfilling Conventional Criteria[J].Neurologist,2017,22(6):219-226.
[4] Wang R,Mei B,Liao X,et al.Determination of risk factors affecting the in-hospital prognosis of patients with acute ST segment elevation myocardial infarction after percutaneous coronary intervention[J].BMC Cardiovasc Disord,2017,17(1):243-248.
[5] Hashani M,Witzel HR,Pawella LM,et al.Widespread expression of perilipin 5 in normal human tissues and in diseases is restricted to distinct lipid droplet subpopulations[J].Cell Tissue Res,2018,374(1):121-136.
[6] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志,2015,43(5):380-393.
[7] 朱可夫,王玉茗,俞勤凯,等.冠心病患者血清脂滴蛋白5水平改变及相关因素的研究[J].中华老年心脑血管病杂志,2017,19(8):816-820.
[8] 宋萍,王贺,司春婴,等.冠状动脉支架内新生动脉粥样硬化的发病机制及化痰活血治疗研究进展[J].山东医药,2019,59(27):94-97.
[9] 高淑娟,江文艳.联合检测超敏肌钙蛋白Ⅰ和心肌酶在急性冠脉综合征的临床意义[J].血栓与止血学,2018,24(5):72-74+77.
[10] 李航,赵振广,卢晓朝,等.Perilipin5基因功能结构域载体的构建及亚细胞定位分析[J].现代生物医学进展,2014,14(5):805-810.
[11] Hashani M,Witzel HR,Pawella LM,et al.Widespread expression of perilipin 5 in normal human tissues and in diseases is restricted to distinct lipid droplet subpopulations[J].Cell Tissue Res,2018,374(1):121-136.
[12] 曹开宇,高星,袁媛,等.阿托伐他汀抑制Perilipin5表达降低肝脏脂质储积的病理学分析[J].临床与实验病理学杂志,2018,34(5):492-497.
[13] Knapp M,Gorski J.The skeletal and heart muscle triacylglycerol lipolysis revisited[J].J Physiol Pharmacol,2017,68(1):3-11.
[14] Trevino MB,Mazur-Hart D,Machida Y,et al.Liver perilipin 5 expression worsens hepatosteatosis but not insulin resistance in high fat-fed mice[J].Mol Endocrinol,2015,29(10):1414-1425.
[15] 李航.LSDP5在肝脏脂肪和脂滴代谢中的作用及机制研究[D] .西安:第四军医大学,2011.
[16] 王瑞钰,张清,沈健,等.低蛋白血症与急性ST段抬高型心肌梗死患者冠脉病变及预后的相关性研究[J].重庆医科大学学报,2017,42(2):225-231.
[17] 高秀鑫,丁振江,王文丰,等.三酰甘油/高密度脂蛋白胆固醇比值与冠心病的患病风险[J].临床心血管病杂志,2019,35(12):1085-1088.
[18] Trevino MB,Machida Y,Hallinger DR,et al.Perilipin 5 regulates islet lipid metabolism and insulin secretion in a cAMP-dependent manner:implication of its role in the postprandial insulin secretion[J].Diabetes,2015,64(4):1299-1310.
[19] Arimura N,Horiba T,Imagawa M,et al.The peroxisome proliferator-activated receptor regulates expression of the perilipin gene in adipocytes[J].J Biol Chem,2004,279(11):10070-10076.
-
计量
- 文章访问数: 95
- PDF下载数: 25
- 施引文献: 0
下载: