急诊血运重建对急性心肌梗死患者心脏胶原合成与降解的影响  

Effects of emergency revascularization on myocardial collagen synthesis and degradation in patients with acute myocardial infarction

作　　者：吴强[1] 黄山[2] 刘相飞[1] 张静[1] 张雪松[1] 彭林林[1] 张晓丽[1] 

机构地区：[1]贵州省人民医院心内科,贵阳550002 [2]贵州省临床检验中心

出　　处：《临床心血管病杂志》2009年第9期674-676,共3页Journal of Clinical Cardiology

基　　金：贵州省科学技术基金资助项目[黔基合计字(2003)3043];贵州省高层次人才科研条件特助经费项目[黔人领函(2005)14]

摘　　要：目的:探讨急诊血运重建对急性心肌梗死(AMI)患者心脏胶原合成和降解代谢的影响。方法:对33例AMI患者分别予常规药物治疗(常规组,14例)和急诊血运重建治疗(急诊组,19例),应用酶联免疫法分别检测AMI后1周、6个月及12个月的血清Ⅰ型前胶原羧基端肽(PⅠCP)、Ⅲ型前胶原(PCⅢ)、基质金属蛋白酶-1(MMP-1)及组织抑制因子-1(TIMP-1)含量。以30例正常人为对照组。结果:与对照组比较,常规组和急诊组各时点的PⅠCP、PCⅢ均明显增高(P<0.05),MMP-1和TIMP-1均显著降低(P<0.05)。急诊组6个月的PⅠCP、PCⅢ和12个月的PCⅢ均低于常规组同期相应指标(P<0.05),急诊组6个月的TIMP-1高于同期常规组(P<0.05)。结论:急诊血运重建抑制AMI后中期(6～12个月)心脏胶原重构的作用强于常规药物治疗。Objective：To investigate the effects of emergency revascularization on myocardial collagen synthesis and degradation in patients with acute myocardial infarction （AMI）. Method：According to the different therapies,thirty-three patients with AMI were divided into the conventional therapy group （n=14） and the emergency revascularization group （n=19）. Serum level of carboxy-terminal propeptide of procollagen typeⅠ （PⅠCP）,precollagen type Ⅲ （PCⅢ）,matrix metalloproteinase-1 （MMP-1） and tissue inhibitor-1 （TIMP-1） were measured by enzyme-linked immunosorbent assay at the 1st week,the 6th month,and the 12th month after AMI. Thirty healthy persons served as normal control. Result：Compared with the control group,serum concentration of PⅠCP and PCⅢ in all time frames after AMI were increased,whereas MMP-1 and TIMP-1 in all time frames were decreased significantly. Plasma levels of PⅠCP at the 6th month and PCⅢ at the 6th month and the 12th month were significantly lower,as well as TIMP-1 at the 6th month was higher,in emergency revascularization group than those in conventional therapy group respectively. Conclusion：Emergency revascularization appears to be superior to conventional therapy with respect to suppression of myocardial collagen synthesis and degradation in patients with AMI.

关 键 词：心肌梗死 血运重建 胶原 重构 

分 类 号：R542.22[医药卫生—心血管疾病]