急性心肌梗死后血清GM-CSF水平变化及其与心功能的相关性  

Serum profiles of circulating granulocyte-macrophage colony-stimulating factor after acute myocardial infarction and its relation with ventricular function

作　　者：付真彦[1] 马依彤[1] 杨毅宁[1] 黄定[1] 艾尔肯[1] 张建发[1] 刘芬[1] 

机构地区：[1]新疆医科大学第一附属医院心血管研究中心,新疆乌鲁木齐830054

出　　处：《心脏杂志》2008年第5期581-583,共3页Chinese Heart Journal

基　　金：新疆高校科研计划创新群体基金资助(XJEDU2005G03);新疆教委内科重点学科基金资助(200501)

摘　　要：目的研究急性心肌梗死（AMI）后患者血清粒细胞-巨噬细胞集落刺激因子（GM-CSF）水平变化，及其与心功能的关系。方法AMI患者30例，AMI后8，16，24，36，48h及3，4，5，6，7d分别测定血清GM-CSF，肌酸激酶同工酶（CK-MB）浓度。并在AMI1周后测量左室射血分数（LVEF），左室舒张末期内径（LVEDD）。从30例患者中选取5例急性广泛前壁心梗，并且LVEF〈40％的患者作为亚组，描述心梗后GM—CSF时间相；并分析30例患者血清GM—CSF峰值与心梗后心功能的关系。结果GM—CSF在AMI后8h开始逐渐升高，36～72h达高峰，在以后7d的测量中均保持较高水平。GM—CSF峰值与CK—MB峰值呈正相关（r=0．566，P〈0．05）；与LVEF呈负相关（r=-0．42，P〈0．05）；与LVEDD呈正相关（r=0．454，P〈0．05）。结论心肌梗死后血清GM—CSF水平增高与心功能呈负相关。AIM To investigate the kinetics of granulocyte-macrophage colony-stimulating factor （ GM- CSF） in the serum of patients with acute myocardial infarction （AMI） and its relation with post-infarction ventricular function. METHODS Serum levels of GM-CSF and creatine kinase isoenzyme （ CK-MB ） were determined serially in 30 AMI patients （after AMI 8 h, 16 h, 24 h, 36 h, 48 h, 3 d, 4 d, 5 d, 6 d, 7 d ）. Left ventrieular ejection fraction （LVEF） and left ventricular end-diastolic dimension （LVEDD） were determined one week after AMI. Out of the 30 patients, 5 patients with extensive anterior wall infarction, LVEF 〈 40% formed a subgroup to describe the graph of GM-CSF. The relation between the peak level of GM-CSF and ventricular function were also explored in the 30 patients. RESULTS Serum GM-CSF activities increased at 〈 8 h and peaked at 36 -72 h after the attack, remaining elevated 〉 7 days. Significant correlations were observed between the peak of GM-CSF levels and the peak of serum CK-MB （r =0. 566, P 〈0. 05） and between the peak GM-CSF levels and LVEF （r = -0. 42, P 〈0. 05）, LVEDD （r =0. 454, P 〈 0. 05）. CONCLUSION GM-CSF elevates during the course of AMI and is negatively correlated with left ventricular function.

关 键 词：粒细胞-巨噬细胞集落刺激因子 心肌梗死 急性 心肌重构 

分 类 号：R541.4[医药卫生—心血管疾病]