急性心肌梗死患者全身与局部血浆组织蛋白酶抑制素水平的变化  

The Changes of Systemic and Local Plasma Cathelicidin LL-37 Levels in Patients With Acute Myocardial Infarction

作　　者：赵汉军[1] 颜红兵[1] 李文铮[2] 刘臣[2] 陈艺[2] 周鹏[2] 赵博[2] 迟云鹏[2] 王韶屏[2] 宋莉[1] 

机构地区：[1]中国医学科学院 北京协和医学院心血管病研究所 阜外心血管病医院心血管疾病国家重点实验室,北京市100037 [2]首都医科大学附属北京安贞医院

出　　处：《中国循环杂志》2012年第3期170-173,共4页Chinese Circulation Journal

基　　金：北京市自然科学基金(7082030);北京市优秀人才基金(20081D0300600080);首都医科大学临床基础合作课题(2007JL42)

摘　　要：目的:联合抽吸导管局部(罪犯血管)取样,评价急性ST段抬高心肌梗死(STEMI)时全身(主动脉根部)与局部血浆组织蛋白酶抑制素(LL-37)水平的变化。方法:连续入选我院履行知情同意且接受冠状动脉造影(冠造)的男性患者122例,无动脉粥样硬化性冠心病(无CAD)组31例、稳定CAD组44例、STEMI组47例。STEMI组接受急诊冠状动脉介入治疗(PCI)和血栓抽吸。全身血样经造影导管取自主动脉根部,局部血样(STEMI组)经抽吸导管取自罪犯血管。STEMI组的最后6例患者在冠状动脉介入治疗术前、冠状动脉介入治疗术后即刻和发病第1、3、5天采集外周静脉血。夹心酶联免疫吸附法(ELISA)测定血浆LL-37水平。结果:STEMI组全身血浆LL-37水平较无CAD组、稳定CAD组降低,差异有统计学意义(P=0.001～0.009)。STEMI组局部血浆LL-37水平高于全身,差异有统计学意义(P=0.013)。多时间点取样观察STEMI组6例患者全身血浆LL-37水平变化:发病第1天、第3天、第5天比冠状动脉介入治疗术前及术后即刻均升高(P=0.000～0.002)。结论:STEMI患者全身血浆LL-37水平下降并在发病1天后升高,而STEMI时闭塞罪犯血管局部血浆LL-37水平高于其全身,提示LL-37可能在STEMI发病中起着重要作用。Objective：To investigate the changes of systemic and local（ culprit artery）plasma cathelididin LL-37 levels in patients with acute ST-segment elevation myocardial infarction（STEMI）. Methods：A total of 122 consecutive male patients who received coronary angiography in our hospital were summarized. The patients were at 18 -75 years of age and divided into 3 groups. Non-coronary artery disease （CAD）group, n = 31, Stable CAD group, n = 44 and STEMI group, n = 47. STEMI patients received PCI and thrombus suction. Systemic blood sample was taken from the root of aorta,local blood sample was from culprit artery, and plasma LL-37 level was measured by ELISA. LL-37 level from peripheral vein was also examined in the last 6 patients in STEMI group at pre-PCI,immediately post-PCI, and 1,3 and 5 days af- ter heart attack. Result：The systemic LL-37 level decreased in STEMI group than those in Non-CAD group and Stable CAD group, P= 0. 001 - 0. 009. Peripheral plasma LL-37 levels in 6 STEMI patients were higher at 1,3 and 5 days after heart attack than those at pre-PCI or immediately post-PCI,P=0. 000 - 0. 002. In STEMI group,the local LL-37 level was higher than that in systemic level,P=0. 013. Conclusion：In STEMI patients, the local level of LL-37 was higher than that in systemic level,which may suggest that LL-37 could play an important role in STEMI occurrence.

关 键 词：急性心肌梗死 组织蛋白酶抑制素 炎症 

分 类 号：R541[医药卫生—心血管疾病]