急性ST段抬高心肌梗死患者血浆内脂素水平及临床意义  

The changes and clinical significance of plasma visfatin level in patients with ST-segment elevation myocardial infarction

作　　者：张志能[1] 欧阳平[1] 马晓玲[1] 贝伟剑[2] 赖文岩[1] 许顶立[1] 

机构地区：[1]广州南方医科大学南方医院心血管内科,广东广州510515 [2]广东药学院中医药研究院,广东广州510006

出　　处：《广东药学院学报》2013年第1期83-88,共6页Academic Journal of Guangdong College of Pharmacy

基　　金：广州市科信局基金项目(2010UI-E00531-11)

摘　　要：目的探讨急性ST段抬高心肌梗死患者血浆内脂素水平变化及其临床意义,评价其作为潜在生物标记物对ST段抬高急性心肌梗死的诊断价值。方法设置急性ST段抬高心肌梗死组(23例)、慢性心绞痛组(38例)及非冠心病对照组(19例),对临床入选患者均行冠状动脉造影,并行外周血内脂素、心肌肌钙蛋白I、心肌酶、N末端B型脑钠肽原(NT-proBNP)、白细胞总数、心电图、超声心动图等检测,分别观察血浆内脂素水平与急性ST段抬高心肌梗死各指标、超声心动图参数及冠状动脉病变血管数的相关性。结果①急性ST段抬高心肌梗死组血浆内脂素水平显著高于慢性心绞痛组及非冠心病对照组,且分别与心肌肌钙蛋白I、心肌酶、NT-proBNP、白细胞总数、中性粒细胞总数及单核细胞总数呈正相关,与超声心动图参数左室射血分数呈负相关(P<0.05)。②血浆内脂素水平随冠状动脉病变血管数的增加而升高,与单支血管病变及双支血管病变组分别比较,多支血管病变组血浆内脂素水平显著升高,差异有统计学意义(P<0.05)。结论急性ST段抬高心肌梗死患者血浆内脂素水平升高与心肌损伤标记物、左室射血分数及冠脉血管病变的严重程度密切相关,可作为缺血性心肌损伤的一种潜在性标记物进行进一步的研究。Objective To investigate the changes and significance of plasma visfatin level in patients with ST-segment elevation myocardial infarction（STEMI）.Method Patients were divided three groups,including 23 patients with STEMI,38 patients with chronic angina and 19 patients with non-coronary heart disease.The examination content included coronary angiography,electrocardiogram,echocardiography,plasma visfatin,cardiac troponin I,myocardial enzyme,N-terminal pro-B-type brain natriuretic peptide（NT-proBNP）,total white blood cells count,neutrophil count and monocyte count.The correlation between plasma visfatin level and relevant parameters such as cardiac troponin I,NT-proBNP,echocardiography and the number of diseased coronary arteries in STEMI patients was analyzed.Result Compared to the chronic angina and non-coronary heart disease patients,the levels of plasma visfatin were significantly elevated in acute STEMI patients.Increasing concentrations of visfatin were positively associated with cardiac troponin I,myocardial enzyme,NT-proBNP,total white blood cells count,neutrophil count and monocyte count,but were negatively associated with left ventricle ejection fraction and left ventricle end-systolic diameter（P〈0.05）.The levels of plasma visfatin were significantly elevated in patients with multi-coronary arteries lesion compared with that of patients with single and double-coronary arteries lesion（P〈0.05）.Conclusion The level of plasma visfatin may be significantly elevated in STEMI patients,which is closely related to biomarkers of myocardial damage,left ventricle ejection fraction and the number of diseased coronary arteries.

关 键 词：急性ST段抬高心肌梗死 内脂素 心肌肌钙蛋白I 

分 类 号：R542.22[医药卫生—心血管疾病]