2023 年第 2 期 第 18 卷

强直性脊柱炎合并急性心肌梗死患者的临床特点分析

Clinical characteristics of patients of ankylosing spondylitis complicated with acute myocardial infarction

作者：高娜李涛涛潘丽丽

英文作者：Gao Na Li Taotao Pan Lili

单位：首都医科大学附属北京安贞医院风湿免疫科，北京100029

英文单位：Department of Rheumatism and Immunology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：强直性脊柱炎；急性心肌梗死；Gensini评分

英文关键词：Ankylosingspondylitis;Acutemyocardialinfarction;Gensiniscore

• 摘要：

• 目的 分析强直性脊柱炎(AS)合并急性心肌梗死(AMI)患者的临床特点。方法 回顾性选取2002年1月至2022年4月于首都医科大学附属北京安贞医院住院治疗的38例AS合并AMI患者作为观察组，另选取同期住院治疗的38例单纯AMI患者作为对照组。比较2组一般资料、Gensini评分、实验室检查指标、心电图及超声心动图指标。结果 观察组AMI发病年龄明显小于对照组［（50±10）岁比（65±9）岁］（P＜0.05），2组男性、吸烟史、糖尿病、高血压病、高脂血症、脑卒中史比例及Gensini评分比较，差异均无统计学意义（均P＞0.05）。观察组C反应蛋白水平明显高于对照组［（5.2±2.8）mg/L比（4.7±3.4）mg/L］ （P＜0.05），2组白细胞计数、血红蛋白、血小板计数、白蛋白、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇及B型脑钠肽水平比较，差异均无统计学意义（均P＞0.05）。观察组左心室舒张末期内径明显小于对照组（P＜0.05）。2组心率、PR间期、QRS时限、QTc间期、主动脉根部内径、室间隔厚度、右心室前后径及左心室射血分数比较，差异均无统计学意义（均P＞0.05）。结论 与单纯AMI患者相比，AS合并AMI患者AMI发病年龄更小、炎症反应程度更高。

• Objective To analyze the clinical characteristics of patients of ankylosing spondylitis (AS) complicated with acute myocardial infarction (AMI). Methods  From January 2002 to April 2022, 38 patients of AS complicated with AMI admitted to Beijing Anzhen Hospital, Capital Medical University were retrospectively enrolled as the observation group. Another 38 patients of single AMI in the hospital were enrolled as the control group. The general data, Gensini score, clinical laboratory indexes, electrocardiogram and echocardiogram indexes were compared between the two groups. Results  The age of AMI onset in the observation group was significantly younger than that in the control group ［（50±10）years vs（65±9）years］(P<0.05). There were no significant differences in rates of male, smoking history, diabetes mellitus, hypertension, hyperlipidemia, stroke history, and Genisni score between the two groups(all P>0.05). The level of C-reactive protein in the observation group was significantly higher than that in the control group［（5.2±2.8）mg/L vs（4.7±3.4）mg/L］(P<0.05). There were no significant differences in levels of white blood cell count, hemoglobin, platelet count, albumin, triacylglycerol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and brain natriuruetic peptide between the two groups(all P>0.05). Left ventricular end diastolic diameter in the observation group was significantly smaller than that in the control group(P<0.05). There were no significant differences in heart rate, PR interval, QRS duration, QTc interval, aortic root internal diameter, interventricular septum thickness, right ventricular anteroposterior diameter and left ventricular ejection fraction between the two groups(all P>0.05). Conclusion  Patients of AS complicated with AMI have younger morbidity age of AMI and higher degree of inflammatory response compared to patients of single AMI.