入院血钠水平与急性心肌梗死介入治疗患者预后的关系研究
Relationship between blood sodium level on admission and the prognosis of patients with acute myocardial infarction undergoing interventional therapy

王晶.入院血钠水平与急性心肌梗死介入治疗患者预后的关系研究[J].内科急危重症杂志,2017,23(6):476-477

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DOI：10.11768/nkjwzzzz20170610

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作者	单位	E-mail
王晶	上海市浦东新区公利医院	gq62743@163.com

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中文摘要:

目的:探讨入院血Na+水平与急性心肌梗死（AMI）介入治疗预后的关系。方法:回顾性分析150例AMI患者的临床资料，按患者入院即刻、入院24、48h 血Na+水平最低值将其分为正常组45例（血Na+>135mmol/L）、轻度低钠组75例（轻度组，血Na+120~135mmol/L）、重度低钠组30例（重度组，血Na+<120mmol/L），所有患者均完成介入治疗，比较各组肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、肌钙蛋白（cTnI）水平、左室射血分数（LVEF）、心肌梗死面积等指标的差异，统计住院30d患者病死率。结果: 3组空腹血糖、血脂水平比较差异无统计学意义（均P>0.05）。轻度组CK-MB、cTnI水平高于正常组（均P<0.05），重度组CK、CK-MB、cTnI水平均高于轻度组与正常组（P<0.05）。正常组LVEF高于轻度组、重度组，且轻度组高于重度组（均P<0.05）。重度组心肌梗死面积大于轻度组与正常组，且轻度组大于正常组（均P<0.05）。重度组病死率高于轻度组与正常组,存活患者血Na+水平高于死亡患者（P<0.05）。结论:AMI患者低钠血症程度与CK、CK-MB、cTnI水平、心肌梗死面积、住院30d病死率呈负相关，与LVEF水平呈正相关。

英文摘要:

Objective: To investigate the relationship between the blood sodium (Na+) level on admission and the prognosis of patients with acute myocardial infarction (AMI) undergoing interventional therapy. Methods: The clinical data of 150 patients with AMI were retrospectively analyzed, and according to the minimum blood Na+ levels on admission and at 24h, 48h after admission, the patients were divided into the normal group (the Na+ level>135mmol/L,n=45), mild hyponatremia group (mild group, the Na+ level of 120~13mmol/L, n=75) and severe hyponatremia group (severe group, the Na+ level<120mmol/L,n=30). All patients completed the interventional therapy. Levels of creatine kinase (CK), creatine kinase isoenzyme (CK-MB) and cardiac troponin I (cTnI), the left ventricular ejection fraction (LVEF) and myocardial infarction area were compared between groups, and the mortality rate of hospitalized patients within 30 days was statistically analyzed. Results: There was no significant difference in levels of fasting blood glucose or blood lipids between groups (P>0.05). Levels of CK-MB and cTnI were higher in the mild group than in the normal group (P<0.05), and levels of CK, CK-MB and cTnI were higher in the severe group than in the mild group or the normal group (P<0.05). LVEF showed the normal group > the mild group > severe group (all P<0.05), while the myocardial infarction area showed the severe group > the mild group > the normal group (P<0.05). The mortality rate of the severe group was higher than that of the mild group or the normal group, and the blood Na+ levels in survival group were higher than those in death group (P<0.05). Conclusion: Hyponatremia is negatively correlated with CK, CK-MB, cTnI, myocardial infarction area and mortality rate in 30 days of hospitalization in patients with AMI, and positively correlated with LVEF.