急性心肌梗死患者血清PⅢP浓度的变化与左室重构的关系  

Relationship between the changes of procollagen Ⅲ and left ventricular remodeling after acute myocardial infarction

作　　者：王圣[1] 孙翠芳[1] 李新明[1] 刘宇飞[2] 丁彦春[2] 曲鹏[2] 

机构地区：[1]海南省人民医院心内科,海南海口570311 [2]大连医科大学附属第二医院心内科,辽宁大连116024

出　　处：《海南医学》2005年第5期1-3,共3页Hainan Medical Journal

摘　　要：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 explore the relationship between the sequential changes in serum levels of procollagen Ⅲ PⅢP and left ventricular remodeling after acute myocardial infarction AMI. Methods Serum concentration of PⅢP was measured by radioimmunoassay at baseline and 147 day and 136 month in 43 patients after AMI. All the patients were divided into remodeling group and non-remodeling group according to their results of the sixth month echocardiography. The relationship between the sequential changes PⅢP and left ventricular remodeling was analyzed. Results Serum levels of PⅢP were much higher in remodeling group than in non-remodeling group all the while. Six months after AMI the levels of left ventricular ejection fraction LVEF and the ratio between peak mitral flow velocities of early and late diastole E/A were correlated negatively with the maximal values of PⅢP r=-0.323,P<0.05; r=-0.359,P<0.05 and left ventricular end-diastolic diameter LVED were correlated positively with the maximal values of PⅢP(r=0.421,P<0.01). In patients with reperfusion of the infarct related artery a decrease of the maximal levels of PⅢP was found significantly in the reperfusion group than that of the non- reperfusion group(99.4±24.7 vs 124.6±27.5 μg/L,P<0.05). Conclusions Serum level of PⅢP is a useful marker reflecting the degree of left ventricular remodeling after AMI. Collagen response and myocardium fibrosis are reduced after reperfusion of the infarct related artery and left ventricular function preserved.

关 键 词：心肌梗死 左室重构 胶原 

分 类 号：R542.2[医药卫生—心血管疾病]