血清胰岛素样生长因子1与急性心肌梗死后左室重构的关系  

Relationship between insulin-like growth factor 1 and left ventricularremodeling in patients with acute myocardial infarction

作　　者：张明[1] 王晓华[1] 

机构地区：[1]江西省人民医院干心内一科,南昌330006

出　　处：《临床心血管病杂志》2013年第5期376-378,共3页Journal of Clinical Cardiology

摘　　要：目的:通过测定急性心肌梗死(AMI)患者血清中胰岛素样生长因子(IGF)-1及其相关结合蛋白(IGFBPs)的浓度,探讨IGF-1及IGFBPs对AMI后左室重构和短期预后的影响。方法:选取AMI患者64例,分别在发病后24h内、48h、72h、1周、3周测定其血清中IGF-1、Free IGF-1、IGFBP-1及IGFBP-3水平,并分别测定24h内、1周、1个月、3个月时的左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)和左室射血分数(LVEF)。64例患者中,心功能较好者(Killip心功能Ⅰ～Ⅱ级)56例,心功能较差者(Killip心功能Ⅲ～Ⅳ级)8例,比较二者间IGF-1、IGFBP-3水平的差异。结果:AMI患者发病后48h和72h总IGF-1水平与发病后1周LVESD(r=-0.421,P=0.016;r=-0.415,P=0.018)、LVEDD(r=-0.490,P=0.004;r=-0.466,P=0.007)均呈负相关,与发病后1周LVEF(r=0.351,P=0.049;r=0.398,P=0.024)呈正相关。心功能较好者IGF-1、IGFBP-3水平明显高于心功能较差者,均差异有统计学意义(均P<0.01)。结论:AMI后血清总IGF-1水平与心室重构呈负相关,与心室功能呈正相关。Objective： By measuring the concentrations of insulin-like growth factor （IGF） 1 and its binding proteins （IGFBPs）, we can explore the relationship between IGF-1 level and left ventricular remodeling in patients with acute myocardial infarction （AMI）. Method：Sixty-four patients with AMI were enrolled. IGF-1, free IGF-1, IGFBP 1 and IGFBP-3 levels were determined in 24 h, 48 h, 72 h, 1st week, 3rd week after AMI respectively, and LVEDD, LVESD, LVEF in 24 h, 1st week, 1st month, 3rd month were determined respectively. We com-pared the levels of IGF 1 and IGFBP-3 between the better heart function （Killip Ⅰ-Ⅱ level, n=56） and poor heart function （Killip Ⅲ-Ⅳ level, n=8）. Result：The total IGF-1 level in 48 h and 72 h after AMI were negative-ly related to LVESD （r=-0.421, P=0.016; r=-0.415, P=0.018） and LVEDD （r=-0.490, P=0.004; r=-0.466, P=0.007） , and positively related to LVEF （r=0.351, P=0.049; r=0.398, P=0.024） in 1st week afler AMI. Compared to the patients with better heart function, those patients with poor heart function had lower total IGF-1 and IGFBP-3 levels immediately after AMI （P〈0.01）. Conclusion： IGF-1 may play an important role in improving left ventricular remodeling and have significantly positive effect to the recovery of cardiac func-tion in patients with AMI.

关 键 词：急性心肌梗死 胰岛素样生长因子1 胰岛素样生长因子结合蛋白1 胰岛素样生长因子结合蛋白3 

分 类 号：R542.2[医药卫生—心血管疾病]