首页|β1-肾上腺素能受体基因多态性对STEMI患者室性心律失常和短期预后的影响

β1-肾上腺素能受体基因多态性对STEMI患者室性心律失常和短期预后的影响

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目的:分析β1-肾上腺素能受体基因多态性对急性ST段抬高型心肌梗死(STEMI)患者室性心律失常以及6个月预后的影响.方法:采用回顾性队列研究方式,按照纳入与排除标准选择云浮市人民医院2021年1月至2023年2月间收治的STEMI患者为研究对象,采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)分析患者β1-肾上腺素能受体Arg389Gly基因型多态性,并根据β1-肾上腺素能受体Arg389Gly基因型多态性类别分为CC组(Arg389Arg,87例)、CG组(Arg389Gly,73例)和GG组(Gly389Gly,18例)三组.对比三组患者收集的入院临床资料[包括Killip分级、心率、收缩压、舒张压、左心室射血分数(LVEF)、左心室舒张末径(LVDD),以及血清肿瘤坏死因子α(TNF-α)、N末端B型利钠肽前体(NT-proBNP)、肌酸激酶同工酶(CK-MB)、超敏C反应蛋白(hs-CRP)等]和出院后通过门诊或电话对其进行6个月随访的结果(包括心率、NT-proBNP、CK-MB、LVEF、LVDD及主要心脏不良事件)的差异.结果:研究共纳入178例STEMI合并室性心律失常的患者,其中CC组有87例(48.9%),CG组有73例(41.0%),GG组有18例(10.1%);三组患者的年龄、性别、体重、BMI、吸烟史、饮酒史、合并疾病、收缩压、舒张压、心率、Killip分级(Ⅲ和Ⅳ级)以及血清TNF-α、NT-proBNP、CK-MB、hs-CRP及LVEF和LVDD均没有显著差异(P>0.05);随访6个月GG组和CG组心功能各项指标结果均显著优于CC组(P<0.05),而GG组的NT-proBNP和CK-MB结果显著低于CG组(P<0.05);统计三组患者随访期间主要心脏不良事件的发生情况,显示CC组的总发生数为17例(19.5%),CG组的总发生数为5例(6.9%),GG组的总发生数为1例(5.6%),组间差异显著(χ2=6.887,P<0.05).结论:β1-肾上腺素能受体Arg389Gly基因多态性与STEMI合并室性心律失常患者的病情严重程度无关,但与治疗后心功能改善情况以及短期预后有关.
Impact of β1-adrenergic receptor gene polymorphism on ventricular ar-rhythmias and short-term prognosis in STEMI patients
AIM:To examine how the variation of the β1-adrenergic receptor gene affects the occurrence of ventricular arrhythmias and the prognosis over a 6-month period in individuals suffering from acute ST-segment elevation myocardial infarction(STEMI).METHODS:A study was conducted retrospectively,where patients diagnosed STEMI and treated at Yunfu City People's Hospital between January 2021 and February 2023 were included based on predefined criteria.The patients were then divided into three groups according to their genotypes of the β1-adrenergic receptor Arg389Gly gene polymorphism:CC group(Arg389Arg),CG group(Arg389Gly),and GG group(Gly389Gly).Discrep-ancies in initial clinical data upon admission[such as Killip classification,heart rate,systolic and diastolic blood pres-sure,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVDD),and serum tumor necro-sis factor alpha(TNF-α),N-terminal pro-B-type natriuretic peptide(NT-proBNP),creatine kinase MB(CK-MB)and high-sensitivity C-reactive protein(hs-CRP)],and outcomes gathered during a 6-month follow-up via telephone after dis-charge(heart rate,NT-proBNP,CK-MB,LVEF,LVDD,and occurrences of major adverse cardiac events)were com-pared across the three groups.RESULTS:The study enrolled a total of 178 STEMI patients with ventricular arrhythmias,comprising 87 cases in CC group(48.9%),73 cases in CG group(41.0%),and 18 cases in GG group(10.1%).There were no notable variances in demographic characteristics such as age,sex,weight,BMI,smoking history,alcohol con-sumption history,comorbidities,blood pressure,heart rate,Killip classification(III amd IV),TNF-α,NT-proBNP,CK-MB,hs-CRP,LVEF and LVDD across the three groups(P>0.05).Following a 6-month monitoring period,the cardiac function parameters in CG and GG groups exhibited significant improvement compared to those in CC group(P<0.05),with noteworthy lower levels of NT-proBNP and CK-MB in GG group in contrast to CG group(P<0.05).Notably,there were significant discrepancies in the incidence of major adverse cardiac events during the follow-up period among the study groups,with 17 cases in CC group(19.5%),5 cases in CG group(6.9%),and 1 case in GG group(5.6%)(χ2=6.887,P<0.05).CONCLUSION:There is no correlation between the severity of STEMI accompanied by ventricular arrhyth-mias and the β1-adrenergic receptor Arg389Gly gene polymorphism.However,this gene variant is connected with en-hancements in cardiac function and short-term prognosis post-treatment.

β1-adrenergic receptoracute ST segment elevation myocardial infarctionventricular arrhyth-miascardiac functionshort-term prognosis

陈嘉莹、何利伟、庄英渠

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云浮市人民医院心血管内科,广东 云浮 527300

南方医科大学南方医院,广东 广州 510000

潮州市中心医院,广东 潮州 521000

β1-肾上腺素能受体 急性ST段抬高型心肌梗死 室性心律失常 心功能 短期预后

广东省卫健委适宜技术推广项目

20230330115846683

2024

中国病理生理杂志
中国病理生理学会

中国病理生理杂志

CSTPCD北大核心
影响因子:1.065
ISSN:1000-4718
年,卷(期):2024.40(9)