QRS碎裂波结合血浆差异代谢物在急性心肌梗死预后中的应用

段雯婷; 路轶晴; 马欣; 王林; 秦少博

doi:10.13201/j.issn.1001-1439.2021.04.007

QRS碎裂波结合血浆差异代谢物在急性心肌梗死预后中的应用

- 1. 西安市第一医院心血管内科(西安,710002);
- 2. 西安市第一医院检验科
基金项目:
陕西省重点研发计划一般项目-社会发展领域(No:2018SF-021)

详细信息

通讯作者: 秦少博,E-mail:qinshaobo06@126.com

中图分类号: R542.2

收稿日期: 2020-11-09

修回日期: 2020-12-31

Application of fragmented QRS combined with plasma differential metabolites in prognosis of acute myocardial infarction

- 1. Department of Cardiology,Xi'an No.1 Hospital, Xi'an, 710002, China;
- 2. Department of Medical Laboratory,Xi'an No.1 Hospital

More Information

Corresponding author: QIN Shaobo, E-mail: qinshaobo06@126.com

Received Date: 09 November 2020

Revised Date: 31 December 2020

摘要

摘要: 目的:基于血浆差异代谢物探讨QRS碎裂波在急性心肌梗死(AMI)预后中的预测作用。方法:通过前期已建立的血浆非靶向代谢组学方法对QRS碎裂波组与无QRS碎裂波组AMI患者血浆样本中的代谢物进行分析,筛选出血浆差异代谢物。利用COX风险比例回归模型计算血浆样本中差异代谢物与患者预后主要心血管不良事件(MACE)以及再住院之间的关系。结果:与QRS碎裂波组相比,无QRS碎裂波组AMI患者预后信息包含MACE及再住院相对较好。通过非靶向代谢组学分析,从血浆样本中共筛选出5个差异代谢物,分别为15-羟二十碳四烯酸、3-羟基丁酸、溶血性磷脂酰胆碱(16∶0)、神经酰胺(d18∶0/18∶0)及色氨酸,其中QRS碎裂波组血浆中15-羟二十碳四烯酸和3-羟基丁酸血浆中相对含量显著高于无QRS碎裂波组,而溶血性磷脂酰胆碱(16∶0)、神经酰胺(d18∶0/18∶0)及色氨酸相对含量显著低于无QRS碎裂波组(P<0.05)。COX回归模型多因素分析显示,3-羟基丁酸(HR=1.36,P=0.037)是有QRS碎裂波的AMI患者PCI术后再发MACE的独立危险因素,而溶血性磷脂酰胆碱(16∶0)(HR=0.57,P=0.013)与色氨酸(HR=0.79,P=0.026)是保护因素;15-羟二十碳四烯酸(HR=1.47,P=0.043)、3-羟基丁酸(HR=1.49,P=0.018)是有QRS碎裂波的AMI患者PCI术后再入院的独立危险因素,而溶血性磷脂酰胆碱(HR=0.50,P=0.002)和神经酰胺(d18∶0/18∶0)(HR=0.78,P=0.048)是保护因素。结论:本研究通过非靶向代谢组学在血浆中筛选出5个差异代谢物,与有QRS碎裂波的AMI患者PCI术后再发MACE和再入院相关,可为今后的干预治疗提供研究依据及研究方向。
- 急性心肌梗死 /
- QRS碎裂波 /
- 差异代谢物 /
- 预后 /
- 代谢组学 /
- 血浆
Abstract: Objective: To clarify the mechanism of fQRS as a predictor of prognostic in acute myocardial infarction(AMI) after PCI through differential plasma metabolites.Methods: An untargeted metabolomics was performed to detect plasma differential metabolites fQRS and non-fQRS in AMI plasma samples by the established method previously. Cox models combined with hazard ratios(HRs) were used to analyze the relationship between differential plasma metabolites and the risk of major adverse cardiovascular events(MACE) and re-admissions from a comparison of fQRS and non-fQRS in AMI.Results: Compared with fQRS group, AMI patients in non-fQRS group had a favorable prognosis including MACE and re-admissions. There were specific differences of endogenous metabolites between fQRS and non-fQRS in AMI plasma samples. A total of 5 differential metabolites(namely 15-HETE, 3-hydroxybutyric acid, LysoPC(16: 0), Cer(d18: 0/18: 0) and tryptophan) were screened finally. The relative concentration of 15-HETE, 3-hydroxybutyric acid in fQRS group were higher than the non-fQRS group, and the relative concentration of LysoPC(16: 0), Cer(d18: 0/18: 0), tryptophan in fQRS group were lower than the non-fQRS group. Multivariate analysis of the COX regression model showed that 3-hydroxybutyric acid(HR=1.36, P=0.037) was independent risk factor for MACE in AMI patients combined with fQRS after PCI. Besides, LysoPC(16: 0)(HR=0.57, P=0.013), tryptophan(HR=0.79, P=0.026) were protective factors.15-HETE(HR=1.47, P=0.043), 3-hydroxybutyric acid(HR=1.49, P=0.018) were independent risk factors for re-admissions in AMI patients combined with fQRS after PCI.LysoPC(16: 0)(HR=0.50, P=0.002), Cer(d18: 0/18: 0)(HR=0.78, P=0.048) were protective factors.Conclusion: In this study, a total of 5 differential plasma metabolites were screened and were found to be associated with the risk of MACE and re-admissions in AMI patients combined with fQRS after PCI, which may provide a theoretical basis for future intervention treatment.
- acute myocardial infarction /
- fragmented QRS /
- differential metabolites /
- prognosis /
- metabolomics /
- plasma

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