急性心肌梗死患者全身与局部血浆α防御素1-3水平的变化  

Level Change of Local and Systemic Plasma Alpha-Defensin 1-3 in Acute Myocardial Infarction

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

机构地区：[1]中国医学科学院 北京协和医学院国家心血管病中心 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28病区,北京市100029

出　　处：《中国动脉硬化杂志》2012年第9期809-813,共5页Chinese Journal of Arteriosclerosis

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)资助

摘　　要：目的评价急性ST段抬高型心肌梗死(STEMI)时全身与局部血浆α防御素1-3(DEFA1-3)水平的变化。方法入选对象均为男性,冠状动脉正常[无冠状动脉粥样硬化性心脏病(CAD)]组31例、稳定型CAD组44例、STEMI组47例。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。夹心酶联免疫吸附法(ELISA)测定血浆DEFA1-3水平。结果全身血浆DEFA1-3水平STEMI组>稳定型CAD组>无CAD组(均P<0.05)。局部与全身血浆DEFA1-3水平差异无显著性(P>0.05)。DEFA1-3诊断STEMI的最佳诊断分界点为136.3μg/L,其敏感度和特异度分别为77.2%和66.7%,受试者操作特征曲线(ROC)曲线下面积(AUC)为0.717(95%CI:0.624～0.811,P=0.000)。结论 STEMI时患者全身血浆DEFA1-3水平升高,有可能作为新型炎性标志物用于急性冠状动脉综合征患者风险或预后评估。Aim To investigate whether systemic or local （culprit artery） plasma alpha-defensin 1-3 （DEFA1- 3） levels are associated with stable coronary artery disease （CAD） and acute ST-segment elevation myocardial infarction （STEMI）. Methods Systemic or local blood samples were obtained from 122 consecutive male subjects including no CAD （n=31） controls, stable CAD （n =44） and STEMI （n=47）. Plasma DEFA1-3 levels were measured by ready- to-use solid-phase enzyme-linked immunosorbent assay （ELISA） based on the sandwich principle. Results Systemic DEFA1-3 in STEMI were increased compared with no CAD （ P 〈 0. 05 ） and stable CAD （ P 〈 0. 05 ）, and systemic DE- FA1-3 in stable CAD were higher than in no CAD （P 〈 0.05）. However, local and systemic levels of DEFA1-3 did not differ （P 〉 0. 05）. Receiver operating characteristic （ROC） analysis revealed that the best cutoff value for systemic DE- FA1-3 levels discriminating STEMI from no CAD and stable CAD was 136. 3 μg/L with a sensitivity of 77. 2%, a specifici- ty of 66.7% and an area under the curve （AUC） of 0.717 （95%CI： 0.624 to 0. 811, P=0.000）. Conclusion STEMI was associated with increased DEFA1-3 in systemic circulation. Future studies should be directed to their prognos- tic values for myocardial infarction.

关 键 词：急性心肌梗死 α防御素 炎症因子 

分 类 号：R5[医药卫生—内科学]