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目的:探讨急性心肌梗死(AMI)患者血清氧化低密度脂蛋白抗体(anti-ox-LDL)的变化及临床意义。方法:68例AMI患者入院时根据临床情况分为静脉溶栓治疗组(Ⅰ亚组,46例)及非溶栓组(Ⅱ亚组,无溶栓适应证或存在禁忌证者22例),同时测定所有患者入院即刻及1个月后血清血脂及anti-ox-LDL水平,各组间进行比较并与对照组比较。结果:①AMI患者入院时血清anti-ox-LDL较对照组明显增高(P<0.01),1个月后显著降低(P<0.001)达对照组水平;②Ⅰ亚组、Ⅱ亚组患者入院时anti-ox-LDL差异无统计学意义;③Ⅰ亚组患者溶栓成功组(26例)与未成功组(20例)入院时anti-ox-LDL差异无统计学意义;④Ⅱ亚组患者急诊冠状动脉造影梗死相关动脉(IRA)末开通者(13例)入院时血清anti-ox-LDL明显高于IRA开通者(9例)。结论:anti-ox-LDL升高与冠状动脉硬化斑块的不稳定性有关,可能是AMI发作的一个危险因素,自发性血管再通可能与血清anti-ox-LDL降低有关,而溶栓所致血管再通则与此无关。
Objective: To investigate the changes of serum anti-ox-LDL in patients with acute myocardial infarction (AMI) and its clinical significance. Methods: Sixty-eight AMI patients were divided into intravenous thrombolytic therapy group (n = 46 in group Ⅰ) and non-thrombolytic group (n = 22 in type Ⅱ). There were 22 patients without thrombolytic indications or contraindications, At the same time, the level of serum lipids and anti-ox-LDL in all patients were measured immediately after admission and one month later, compared with each other and compared with the control group. Results: ①Anti-ox-LDL in patients with AMI was significantly higher (P <0.01) at admission and significantly lower (P <0.001) at 1 month than those in the control group. ② The anti-ox- There was no significant difference between the two groups (P> 0.05). There was no significant difference in anti-ox-LDL between the successful group and the unsuccessful group (21 cases) Serum anti-ox-LDL was significantly higher in IRA patients (n = 13) than in IRA patients (n = 9). Conclusion: The elevated anti-ox-LDL is associated with the instability of coronary atherosclerotic plaque, which may be a risk factor for the onset of AMI. The spontaneous recanalization may be related to the decrease of serum anti-ox-LDL, whereas thrombolysis Revascularization is unrelated to this.