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目的:通过测定急性心肌梗死(AMI)患者血清中胰岛素样生长因子(IGF)-1及其相关结合蛋白(IGFBPs)的浓度,探讨IGF-1及IGFBPs对AMI后左室重构和短期预后的影响。方法:选取AMI患者64例,分别在发病后24h内、48h、72h、1周、3周测定其血清中IGF-1、Free IGF-1、IGFBP-1及IGFBP-3水平,并分别测定24h内、1周、1个月、3个月时的左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)和左室射血分数(LVEF)。64例患者中,心功能较好者(Killip心功能Ⅰ～Ⅱ级)56例,心功能较差者(Killip心功能Ⅲ～Ⅳ级)8例,比较二者间IGF-1、IGFBP-3水平的差异。结果:AMI患者发病后48h和72h总IGF-1水平与发病后1周LVESD(r=-0.421,P=0.016;r=-0.415,P=0.018)、LVEDD(r=-0.490,P=0.004;r=-0.466,P=0.007)均呈负相关,与发病后1周LVEF(r=0.351,P=0.049;r=0.398,P=0.024)呈正相关。心功能较好者IGF-1、IGFBP-3水平明显高于心功能较差者,均差异有统计学意义(均P<0.01)。结论:AMI后血清总IGF-1水平与心室重构呈负相关,与心室功能呈正相关。
OBJECTIVE: To investigate the serum levels of insulin-like growth factor (IGF-1) and its related binding proteins (IGFBPs) in patients with acute myocardial infarction (AMI) and to investigate the effect of IGF-1 and IGFBPs on left ventricular remodeling and short-term prognosis after AMI influences. Methods: Sixty-four AMI patients were selected and their serum levels of IGF-1, Free IGF-1, IGFBP-1 and IGFBP-3 were determined at 24h, 48h, 72h, (LVEDD), left ventricular end-systolic diameter (LVESD) and left ventricular ejection fraction (LVEF) at 1 week, 1 month, 1 month and 3 months after operation. Among the 64 patients, 56 patients had better cardiac function (Killip heart function grade Ⅰ ~ Ⅱ) and 8 patients with poor cardiac function (Killip heart function Ⅲ ~ Ⅳ grade). The levels of IGF-1, IGFBP-3 Horizontal difference. Results: The levels of total IGF-1 at 48h and 72h after AMI patients were significantly higher than those before AMI (P <0.05), and the LVEDD (r = -0.490, P = 0.004) ; r = -0.466, P = 0.007) were negatively correlated with LVEF (r = 0.351, P = 0.049; r = 0.398, P = 0.024) The levels of IGF-1 and IGFBP-3 in patients with better cardiac function were significantly higher than those with poor cardiac function (all P <0.01). CONCLUSION: The level of total IGF-1 in serum after AMI is negatively correlated with ventricular remodeling and positively correlated with ventricular function.