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目的探讨急性心肌梗死(AMI)后血清Ⅲ型前胶原末端肽(PⅢP)浓度的变化与左室重构的关系。方法共43例AMI患者入选,所有入选患者均于入院时及AMI发病的第1、4、7天及第1、3、6月应用放射免疫分析法测定其血清PⅢP浓度的变化。根据AMI6月后彩色多普勒心动超声的结果,按是否存在左室重构将其分为重构组与非重构组,并分析两组PⅢP浓度的变化与左室重构的关系。结果AMI后左室重构患者血清PⅢP浓度持续高于非重构者,血清PⅢP浓度的峰值与6月时LVEF、E/A之间呈负相关(r=-0.323,P<0.05;r=-0.359,P<0.05);与LVED之间呈正相关(r=0.421,P<0.01)。梗死相关动脉(IRA)再灌注患者血清PⅢP峰值浓度明显低于未获灌注者(99.4±24.7vs124.6±27.5μg/L,P<0.05)。结论AMI后血清PⅢP浓度的变化是反映左室重构有用的指标,IRA再灌注可以明显减少梗死后的胶原形成,防止心肌纤维化的形成,改善左室功能。
Objective To investigate the relationship between the change of serum concentration of type Ⅲ procollagen peptide (PⅢP) and left ventricular remodeling after acute myocardial infarction (AMI). Methods A total of 43 patients with AMI were enrolled. All the patients were enrolled in the study. Changes of serum PⅢP concentrations were measured by radioimmunoassay on admission day 1, day 4, day 7, day 1, day 3, and day 6 of onset of AMI. According to the results of AMI6 months after surgery, the left ventricular remodeling is divided into two groups according to whether there is left ventricular remodeling, and the relationship between the changes of PⅢP concentration and left ventricular remodeling. Results The serum PⅢP concentration in patients with left ventricular remodeling after AMI was consistently higher than that in non-remodeling patients. The peak value of serum PⅢP concentration was negatively correlated with LVEF and E / A in June (r = -0.323, P <0.05; r = -0.359, P <0.05) and positively correlated with LVED (r = 0.421, P <0.01). The PⅢP peak concentration in patients with IRA reperfusion was significantly lower than those without IRI (99.4 ± 24.7 vs 124.6 ± 27.5 μg / L, P <0.05). Conclusion The change of serum PⅢP concentration after AMI is a useful indicator of left ventricular remodeling. IRA reperfusion can significantly reduce collagen formation after infarction, prevent the formation of myocardial fibrosis and improve left ventricular function.