关键词:

急性心肌梗死, 消化道微生态, 同型半胱氨酸, 载脂蛋白A, 心力衰竭

Abstract:

Objective　To study the changes of digestive tract microecology and serum levels of homocysteine (Hcy) and apolipoprotein A (Apo-A) in patients with acute myocardial infarction (AMI) and their correlation with heart failure (HF). Methods　A retrospective analysis was conducted on the medical records of 120 patients with AMI treated at the First Affiliated Hospital of Xi'an Medical University from October 2022 to October 2024. They were divided into an HF group (56 cases) and a non-HF group (64 cases) according to whether they were complicated with HF. There were 30 males and 26 females in the HF group, with an age of (55.17±5.26) years, and a disease course of (2.51±0.45) h. There were 35 males and 29 females in the non-HF group, with an age of (55.26±5.32) years and a course of disease of (2.45±0.39) h.The changes of digestive microecology (Bacteroidetes, Bifidobacterium, Enterobacteriaceae, and Enterococcus) and serum levels of Hcy and Apo-A were compared between the two groups, and the correlations of digestive microecology and serum levels of Hcy and Apo-A with HF in the patients were analyzed by the Spearman rank correlation analysis. t test was used as the statistical method. Results　The levels of Bacteroidetes and Bifidobacterium in the HF group were lower than those in the non-HF group [(3.52±0.75) lgCFU/g vs. (6.89±1.32) lgCFU/g and (4.01±0.55) lgCFU/g vs. (7.45±1.46) lgCFU/g], and the levels of Enterobacteriaceae, Enterococcus, Hcy, and Apo-A were higher [(22.36±3.65) lgCFU/g vs. (18.72±3.14) lgCFU/g, (20.92±2.54) lgCFU/g vs. (17.48±2.26) lgCFU/g, (19.22±3.80) μmol/L vs. (16.51±2.45) μmol/L, and (0.62±0.15) g/L vs. (0.40±0.10) g/L], with statistical differences (t=21.870, 16.623, 5.873, 7.851, 4.699, and 9.557; all P<0.05). The Spearman rank correlation analysis showed that the levels of Bacteroidetes and Bifidobacteria were negatively correlated with HF in the patients (r=-0896 and -0.837; both P<0.001), and the levels of Enterobacteriaceae, Enterococcus, Hcy, and Apo-A were positively correlated with HF (r=0.476, 0.586, 0.394, and 0718; all P<0.001). Conclusion　Patients with AMI have gastrointestinal microbiota imbalance and abnormal levels of serum Hcy and Apo-A, which are closely related to the occurrence and development of HF.

Key words:

Acute myocardial infarction, Digestive tract microecology, Homocysteine, Apolipoprotein A, Heart failure