论文部分内容阅读
目的评价冠状动脉粥样硬化性心脏病(冠心病,CAD)患者血清阴离子间隙(AG)水平与CAD患者左心室收缩功能的关系。方法连续入选2004年4月1日~2010年10月31日在5家临床中心就诊的18 115例冠心病患者,均接受了冠状动脉造影检查及经皮冠状动脉介入治疗。血清AG根据以下公式计算:AG=[Na+(mmol/L)+K+(mmol/L)]-[Cl-(mmol/L)+HCO3-(mmol/L)]。根据左室射血分数(LVEF)评估患者的左心室收缩功能。结果共有4510例(24.9%)患者血清AG水平超过16 mmol/L,左室收缩功能不全患者血清AG水平显著升高。血清AG水平最高四分位数组左室收缩功能下降的相对风险(OR)是AG水平最低四分位数组的1.355(未校正,P<0.001)和1.158倍(校正后,P=0.049)。在剔除e GFR<60 ml/(min·1.73 m2)的AKD患者后,血清AG水平仍然是左室收缩功能下降的显著独立相关因素。结论 CAD患者中血清AG升高占有较高的比例,合并心功能不全的患者中比例更高,血清AG水平是左室收缩功能的显著独立相关因素。
Objective To evaluate the relationship between serum anion gap (AG) and left ventricular systolic function in patients with coronary atherosclerotic heart disease (CAD). Methods A total of 18 115 coronary heart disease patients admitted to five clinical centers from April 1, 2004 to October 31, 2010 were enrolled in the study. All patients underwent coronary angiography and percutaneous coronary intervention. The serum AG is calculated according to the following formula: AG = [Na + (mmol / L) + K + (mmol / L)] - [Cl- (mmol / L) + HCO3- (mmol / L)]. Patients were assessed for left ventricular systolic function based on left ventricular ejection fraction (LVEF). Results A total of 4510 patients (24.9%) had serum AG levels above 16 mmol / L and serum AG levels significantly increased in patients with LV systolic dysfunction. The relative risk (OR) for loss of left ventricular systolic function in the highest quartile of serum AG levels was 1.355 (unadjusted, P <0.001) and 1.158 times (adjusted, P = .049) for the lowest quartile of AG levels. After removing AKD patients with e GFR <60 ml / (min · 1.73 m2), serum AG levels remained significant independent independent factors of decreased left ventricular systolic function. Conclusions Serum AG is predominantly elevated in patients with CAD, with a higher proportion of patients with cardiac dysfunction. Serum AG levels are significantly independent independent factors of left ventricular systolic function.