急性心肌梗死患者血清瘦素水平的变化及其临床意义  

Clinical significance of serum leptin measurement in patients with acute myocardial infarction

作　　者：徐彤彤[1] 阳跃忠[1] 

机构地区：[1]桂林医学院附属医院心血管内科,广西桂林541001

出　　处：《临床内科杂志》2007年第2期106-108,共3页Journal of Clinical Internal Medicine

基　　金：广西教育厅资助项目[桂教科研(2004)20号];广西科学基金资助项目(桂科自0640186)

摘　　要：目的探讨瘦素在急性心肌梗死(AMI)发生、发展过程中的变化及其临床意义。方法动态检测40例AMI病人不同病程中的外周血清瘦素水平,并检测20例同期住院的不稳定型心绞痛(UA)病人和20名健康志愿者(对照组)外周血清瘦素。对AMI组病人溶栓24小时后的心电图ST段回落进行检测。依据结果分为ST回落≥50%和ST回落<50%两组。比较溶栓前后的血清瘦素和溶栓后血清瘦素下降百分比。结果(1)AMI组的血清瘦素(15.83±3.51)g/L和UA组的血清瘦素(9.83±3.55)g/L显著高于对照组的血清瘦素(3.68±1.32)g/L,P值均<0.01;AMI组血清瘦素明显高于UA组(P<0.05)。(2)AMI组病人经溶栓治疗后血清瘦素下降。(3)AMI组病人溶栓前血清瘦素水平高低与溶栓后24小时ST段回落相关,ST回落≥50%组的溶栓前血清瘦素显著低于回落<50%组,P<0.01。(4)溶栓24小时后血清瘦素下降程度与24小时ST段回落相关:ST回落≥50%组的瘦素下降率(48.3%±6.2%)明显大于ST回落<50%组的瘦素下降率(10.5%±2.3%),P<0.01;(5)AMI病人血清瘦素与肿瘤坏死因子-α(TNF-α)水平呈正相关。结论瘦素可能参与了AMI心肌损伤过程,动态检测血清瘦素水平有助于判断AMI疾病的进程与疗效。Objective To investigate the change and its clinical significance of level of leptin in serum in patients with acute ,nyocardial infarction （AMI）. Methods The levels of leptin in serum and TNF-α in 40 patients with A MI, 20 patients with unstable angina（UA） and 20 healthy volunteers （CN） as control were assayed by high sensitive radioimmunoassay. In the 40 AMI patients, the ST recovery segment at 24 hours after thrombolysis-was detected. Their leptin taken right before and 24 hours after the thrombolysis treatment were also measured. Results （ 1 ） levels of leptin in serum of the AMI and the UA groups were higher than that of the CN groups（ P 〈 0.01 ）, and the AMI group＇s leptin was higher than the UA group＇ s（P 〈0.05）. （2） The treatment of thrombolysis significantly reduced leptin in patients with AMI. （3）The AMI patients with ST resolution 〉150% have a lower leptin at 0 hour than those with ST resolution 〈50% do. （4）The percentage of leptin reduction 24 hours after thrombolysis treatment correlates with ST resolution and the leptin reduction for the ST ≥50% group was much larger than that for the ST 〈 50% group. （5）There was a positive correlation between the leptin level and the TNF-α level in serum of AMI patients. Conclusion Higher level of leptin in serum may conduce to myocardial deteriorating process and the measurement of leptin level in serum is helpful to estimate the progress and the effectiveness of treatment for AMI patients.

关 键 词：急性心肌梗死 瘦素 冠状动脉疾病 动脉粥样硬化 血栓溶解疗法 

分 类 号：R542.22[医药卫生—心血管疾病]