急性心肌梗死患者Killip心功能分级与血浆促心肌素-1浓度变化的关系  

Relationship between Killip classification and plasma cardiotrophin-1 in patients with acute myocardial infarction

作　　者：王岱岱[1] 姚震[1] 钟江华[1] 顾申红[1] 陈淑芬[1] 张光星[1] 陈跃武[1] 

机构地区：[1]海南医学院附属医院心内科,海口570102

出　　处：《岭南心血管病杂志》2009年第5期354-356,362,共4页South China Journal of Cardiovascular Diseases

基　　金：海南省自然科学基金2002年资助课题(项目编码:30214)

摘　　要：目的探讨急性心肌梗死(acute myocardial infarction,AMI)患者Killip功能分级与血浆促心肌素-1(cardiotrophin-1,CT-1)浓度变化的关系。方法选择2008年4月～2008年10月于海南医学院附属医院心血管内科住院的29例AMI患者为研究对象,根据入院时Killip分级分组,其中KillipⅠ组11例,年龄(64±11)岁;KillipⅡ组10例,年龄(67±15)岁;KillipⅢ组8例,年龄(68±15)岁。另外,选择20例排除CT-1增高疾病的患者为正常对照组,年龄(63±8)岁。收集入选者血清肌酸激酶同工酶、血清肌钙蛋白浓度,并用酶联免疫吸附测定方法测定血浆CT-1浓度,所得数据用SPSS软件包进行统计学分析。结果方差分析显示4组心肌肌钙蛋白I浓度、血清肌酸激酶同工酶浓度、血浆CT-1浓度比较,差异有统计学意义(F=3.709,P<0.05;F=3.617,P<0.05;F=18.343,P<0.05)。KillipⅢ组血浆CT-1浓度高于KillipⅠ组及KillipⅡ(613.25±84.85)pg/mLvs.(299.36±139.56)pg/mL,P<0.05];[(613.25±84.85)pg/mLvs.(394.11±67.89)pg/mL,P<0.05]。Pearson相关分析显示,AMI患者Killip分级与血浆CT-1浓度呈正相关(r2=0.77,P<0.01),与肌酸激酶同工酶峰值呈正相关(r2=0.44,P<0.05),与心肌肌钙蛋白峰值呈正相关(r2=0.39,P<0.05)。AMI患者血浆CT-1浓度与心肌肌钙蛋白峰值呈正相关(r2=0.555,P<0.01),与肌酸激酶同工酶峰值呈正相关(r2=0.614,P<0.01)。结论血浆CT-1浓度在AMI患者中明显升高,其浓度与Killip心功能分级相关。Objectives To evaluate the relationship of cardiac function assessed by Killip classification and plasma cardiotrophin-1 (CT-1) in acute myocardial infarction (AMI). Methods Twenty-nine AMI patients were selected from Cardiology Department of Affiliated Hospital of Hainan Medical College between April 2008 and October 2008. According to Killip classification of the cardiac function at admission, 29 patients with AMI were divided into Killip classⅠ group [n=11, (64±11) years], Killip classⅡgroup [n=10, (67±15) years] and Killip classⅢ group [n=8, (68±15) years]. The patients were compared to 20 heathy subjects [(63±8) years]. The data of serum creatine kinase isoenzyme ( CK-MB) concentrations, cardiac troponin Ⅰ ( cTnI) concentrations were recorded and plasma CT-1 concentrations were measured by enzyme linked immunosorbent assay (ELISA). Data analysis were performed by SPSS software. Results Variance analysis indicated that there were significent differences in the concentrations of plasma CT-1, serum CK-MB and cTnI among the 4 grpups (F=3.709, P<0.05; F=3.617, P<0.05; F=18.343, P <0.05). The mean plasma CT-1 concentrations in Killip Ⅲ patients of AMI was higher than that in Killip class Ⅰ group and that in Killip class Ⅱ group [( 613.25 ±84.85 ) pg / mL vs. ( 299.36 ±139.56) pg / mL, P <0.05;( 613.25 ±84.85) pg / mL vs. ( 394.11 ±67.89) pg / mL, P <0.05]. Correlation analysis indicated that Killip classification correlated with plasma CT-1 concentration (r2=0.77, P<0.01), with serum CK-MB concentration (r2= 0.44, P<0.05), and with cTnI concentration (r2=0.39, P<0.05). Plasma CT-1 concentrations highly correlated with the peak value of CK-MB concentration (r2=0.614, P<0.01) and cTnI concentration (r2=0.555, P<0.01). Conclusions Plasma CT-1 concentrations increased in patients with AMI and were correlated with Killip classification.

关 键 词：心肌梗死 肌酸激酶 肌钙蛋白 促心肌素-1 KILLIP分级 

分 类 号：R542.2+2[医药卫生—心血管疾病]