抗心磷脂抗体与ST段抬高型心肌梗死PCI术后心脏扩大的相关性研究  

Study on the correlation of anticardiolipin antibody and cardiac dilatation after ASTEMI

作　　者：林玲[1] 壮可[1] 寿涛[2] 乌若丹[1] 赵燕[1] 张宏[1] 

机构地区：[1]云南省第一人民医院心内科,昆明市650032 [2]云南省第一人民医院风湿免疫科,昆明市650032

出　　处：《中国心血管病研究》2009年第2期88-90,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的探讨抗心磷脂抗体（ACLA）与ST段抬高型心肌梗死PCI术后心脏扩大及心功能不全的临床关系。方法145例ST段抬高型心肌梗死患者于发病1周行PCI手术，3个月后测定抗心磷脂抗体，复查超声心动图，检测左心房（LA）、左心室（LV）、射血分数（EF）、二尖瓣E峰峰值流速／二尖瓣A峰峰值流速（E／A）等值。结果AcLA—I蜘和ACLA—IgM水平，无心脏扩大心梗组为0．90±0．22和0．98±0．24，显著高于健康对照组的0．80±0．38和0．84±0．36（P〈0．05）；有心脏扩大心梗组为1．16±0．31和1．29±0．34，显著高于无心脏扩大心梗组（P〈0．05）。有心脏扩大心梗组AcLA阳性率为71．43％，显著高于无心脏扩大心梗组的40．45％（P〈0．05）。结论sT段抬高型心肌梗死PCI术后心脏扩大患者存在自身免疫机制，测定ACLA对预测sT段抬高型心肌梗死PCI术后心脏扩大以及心功能不全有一定的临床意义。Objective To observe the correlation of anticardiolipin antibody （ACLA） and cardiac dilatation and heart failure in patients with acute ST-segment elevation myocardial infarction （ASTEMI） after percutaneous coronary intervention （PCI）. Methods 145 patients with ASTEMI were received PCI in one week. The level of ACLA was measured three months later,and echocardiographic examination was reperformed three months later assessing size of LA, LV, EF value and E/A ratio. Results The level of ACLA in group of acute myocardial infarction（AMI） with cardiac dilatation was higher than that of group of AMI without cardiac dilatation significantly （IgG-ACLA ： 1.16 ±0.31, IgM-ACLA ： 1.29 ±0.34 vs 0.90 ±0.22,0.98 ±0.24, P〈0.05 ）, which also was much higher than normal control（P〈0.05 ）. There was a significant difference in the positive rate of ACLA in group of AMI with dilated ventricle compared with that of group of AMI without dilated ventricle （71.43% vs 40.45% ,P〈0.05）. Conclusion The level of ACLA is useful to predict to cardiac dilatation and heart failure after ASTEMI which may due to the autoimmune mechanism.

关 键 词：ST段抬高型心肌梗死 PCI术后 抗心磷脂抗体 超声心动图检测 

分 类 号：R542.2[医药卫生—心血管疾病]