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目的:探讨ABO血型与急性心肌梗死(AMI)患者梗死相关动脉自发再通的相关性。方法:连续入选1 209例AMI患者,根据心肌梗死溶栓治疗临床试验(TIMI)血流程度将患者分为非自发再通组(TIMI 0~1级,n=442)和自发再通组(TIMI 2~3级,n=767),分析研究ABO血型与自发再通发生的关系。结果:本研究显示,与非自发再通组相比,自发再通组中O型血较常见(32.3%vs 24.7%),A型血者较为少见(31.7%vs 24.9%)。同时,我们发现O型血患者的致动脉粥样硬化性胆固醇包括总胆固醇和低密度脂蛋白胆固醇明显低于非O型血患者(P<0.05)。多因素回归分析表明,校正年龄、性别、体重指数、高血压、糖尿病、吸烟、低密度脂蛋白胆固醇及C反应蛋白、血沉、纤维蛋白原、D-二聚体、内皮心肌功能等因素后,O型血可独立预测AMI患者自发再通的发生[比值比(OR)=1.49,95%可信区间(CI):1.10~2.05)],A型血则不利于自发再通的发生(OR=0.65,95%CI:0.48~0.80)。结论:ABO血型与AMI患者自发再通的发生有关。其中,O型血有利于患者自发再通的发生,而A型血不利于自发再通的发生。
Objective: To investigate the correlation between ABO blood type and spontaneous recanalization of infarct-related artery in patients with acute myocardial infarction (AMI). METHODS: A total of 1 209 AMI patients were enrolled in this study. Patients were divided into non-spontaneous recanalization group (TIMI grade 0 ~ 1, n = 442) and spontaneous recanalization group according to the degree of thrombolysis clinical trial (TIMI) TIMI grade 2 ~ 3, n = 767), analyze the relationship between ABO blood group and spontaneous recanalization. RESULTS: This study showed that O-type blood was more common in spontaneous recanalization group (32.3% vs 24.7%) than in non-spontaneous recanalization group, while type A blood was less common (31.7% vs 24.9%). At the same time, we found that atherosclerotic cholesterol in patients with O-type blood, including total cholesterol and low-density lipoprotein cholesterol, were significantly lower than those without non-O blood (P <0.05). Multivariate regression analysis showed that after adjusting for factors such as age, gender, body mass index, hypertension, diabetes, smoking, low density lipoprotein cholesterol and C-reactive protein, erythrocyte sedimentation rate, fibrinogen, D-dimer and endothelial function, O-type blood was independently predictive of spontaneous recanalization in AMI patients (odds ratio (OR) = 1.49, 95% confidence interval (CI): 1.10 to 2.05); type A blood did not favor spontaneous recanalization = 0.65, 95% CI: 0.48 ~ 0.80). Conclusion: ABO blood group is associated with spontaneous recanalization in patients with AMI. Among them, O-type blood is conducive to spontaneous recanalization of patients, and A-type blood is not conducive to the occurrence of spontaneous recanalization.