再灌注心律失常对急性心肌梗死患者心肌细胞凋亡及心功能的影响  

Effects of Reperfusion Arrhythmia on Myocardial Apoptosis and Cardiac Functoin in Patients with Acute Myocardial Infarction

作　　者：张婧[1] 王树岩[1] 陈瑾[1] 秦海[1] 

机构地区：[1]首都医科大学附属北京朝阳医院心脏中心,北京100020

出　　处：《中国医药导刊》2007年第6期453-454,共2页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨急性心肌梗死(AMI)患者再灌注心律失常(RA)对心肌细胞凋亡和心功能影响。方法:122例经急诊再灌注治疗的AMI患者,依据有无RA分为RA组(n=43)及无RA组(Non-RA组,n=79)。应用ELISA方法检测再灌注治疗成功后7天及4周血清细胞凋亡信号分子Fas/APO-1水平,1年后随访患者心功能。结果:两组患者性别、年龄、梗死部位、入院时心功能Killip分级无显著差异。(1)再灌注治疗成功后7天RA组血清Fas/APO-1浓度与Non-RA组无统计学差异(P>0.05),4周时RA组血清Fas/APO-1浓度明显高于Non-RA组(P<0.01);(2)AMI再灌注治疗成功1年后,RA组心功能NYHA分级高于Non-RA组(P<0.001)。结论:AMI患者早期成功地进行再灌注治疗,但发生RA患者,心肌细胞凋亡重,远期心功能较未发生心律失常患者差。Objective：To investigate effects of reperfusion arrhythmias （RA） on apoptosis and cardiac function in patients with acute myocardial infarction （AMI）. Methods： 122 patients with AMI who underwent primary percutaneous intervention were divided into RA group（n = 43） and non RA group （n = 79） .According to the presence of RA. Strepavidin - biotin ELISA was used to determine the soluble Fas/APO - 1 plasma concentration at 7day and 4week. Cardiac function was evaluated one year later according to the stundard of New York Heart Association. Results： There was no difference between two groups in the basic characteristics, such as sex, age, infarction position and Killip cardiac function. （ 1）The Fas/APO - 1 levels were no difference between two groups at 7day （P 〉 0.05）, the Fas/APO - 1 levels in patients of RA group higher than those of Non - RA group at 7day and 4week （P 〈 0.01 ）. （2） One year later, the cardiac function of patients in RA group was higher than that of Non - RA group（P 〈 0.001） . Conclusion： RA was related with cardiomyecytes apoptosis in patients with AMI, and might influence left ventricular function long - tenn.

关 键 词：急性心肌梗死 再灌注心律失常 细胞凋亡 心功能 

分 类 号：R541.7[医药卫生—心血管疾病] R542.22[医药卫生—内科学]