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目的:探讨ABO血型与急性心肌梗死(AMI)及血脂的相关性。方法:连续收集2014-01-2015-01于重庆医科大学附属第一医院经选择性冠状动脉造影明确诊断为冠心病的患者1 004例。分析ABO血型与冠心病患者AMI发病率及血脂水平之间的关系。结果:1 004例冠心病患者中,A血型组AMI发病率(45.57%)显著高于非A血型组(38.48%)(P<0.05);O血型组AMI的发病率(35.29%)风险显著低于非O血型组(43.59%)(P<0.05)。A血型组的总胆固醇(TC)水平及低密度脂蛋白胆固醇(LDL-C)水平明显高于非A血型组(均P<0.01)。O血型组的LDL-C水平明显低于非O血型组(P<0.05),2组TC水平差异无统计学意义(P>0.05)。经Logistic多元回归分析摸型进行统计学分析,在调整年龄、性别、高血压病史、糖尿病病史、吸烟史、胆固醇水平后,A血型是冠心病患者发生AMI的独立危险因素(OR=1.489,95%CI 1.028~2.155,P<0.05)。中介分析模型显示,无论以模型非A血型/A血型还是模型非O血型/O血型进行分析差异均无统计学意义。结论:A血型是冠心病患者发生AMI的独立危险因素,血脂参数TC、LDL-C、脂蛋白α未在ABO血型与冠心病患者发生AMI的相关性中起中介作用。
Objective: To investigate the relationship between ABO blood type and acute myocardial infarction (AMI) and blood lipids. Methods: A total of 1 004 patients with coronary heart disease confirmed by selective coronary angiography at the First Affiliated Hospital of Chongqing Medical University were collected from January 2014 to January 2015. The relationship between ABO blood group and AMI incidence and blood lipid level in patients with coronary heart disease was analyzed. Results: The incidence of AMI in A blood group (45.57%) was significantly higher than that in non-A blood group (38.48%) in 1 004 patients with coronary heart disease (P <0.05). The incidence of AMI in O blood group was significantly (35.29% Lower than non-O blood group (43.59%) (P <0.05). The level of total cholesterol (TC) and the level of low density lipoprotein cholesterol (LDL-C) in blood group A were significantly higher than those in non-blood group A (all P <0.01). The level of LDL-C in O blood group was significantly lower than that in non-O blood group (P <0.05). There was no significant difference in TC level between the two groups (P> 0.05). Logistic multivariate regression analysis of the touch pattern for statistical analysis, in adjusting for age, gender, history of hypertension, history of diabetes, smoking history, cholesterol levels, blood type A coronary heart disease patients with AMI was an independent risk factor (OR = 1.489,95 % CI 1.028 ~ 2.155, P <0.05). Intermediary analysis showed no significant difference between the non-A blood group / A blood group and the non-O blood group / O blood group. CONCLUSION: Blood type A is an independent risk factor for AMI in patients with coronary heart disease. Lipid parameters TC, LDL-C and lipoprotein α play an intermediary role in the relationship between ABO blood group and AMI in patients with coronary heart disease.