急性心肌梗死患者血浆骨桥蛋白变化与左心室重构  

Plasma osteopontin level and left ventricular remodeling in patients with acute myocardial infarction

作　　者：孟磊[1] 王洁[1] 丁文惠[1] 杨颖[1] 齐丽彤[1] 霍勇[1] 

机构地区：[1]北京大学第一医院心内科,北京100034

出　　处：《北京大学学报（医学版）》2013年第4期630-633,共4页Journal of Peking University:Health Sciences

摘　　要：目的:研究骨桥蛋白在急性ST段抬高心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者血浆中水平的变化及其与左心室重构和预后的关系。方法:入选STEMI患者61例,于入院时、第3天及第7天取静脉血,另选健康对照63例,ELISA方法检测骨桥蛋白,并比较骨桥蛋白与临床指标、生化标志物及STEMI 3个月后左心室重构指标的关系。结果:STEMI患者入院即刻血浆骨桥蛋白即明显升高[(96.51±37.22)μg/L vs.(54.50±28.17)μg/L,P<0.001],至第3天达到峰值,第7天有所下降,但均显著高于健康对照组(P<0.05)。相关分析显示,骨桥蛋白与年龄呈弱正相关,与STEMI 3个月后左心室收缩末容积指数(left ventricular end-systolicvolume index,LVESVI)呈弱正相关(r=0.413,P=0.019),与3个月时左心室射血分数(left ventricular ejection frac-tion,LVEF)呈弱负相关(r=-0.383,P=0.031)。随访研究未发现骨桥蛋白水平与患者发生死亡、再梗死、脑卒中、再次血运重建、因心力衰竭住院等心脏事件相关。结论:STEMI患者急性期骨桥蛋白水平升高,骨桥蛋白可能参与了左心室重构。Objective：To investigate the change of plasma osteopontin level during the progress of acute ST-segment elevation myocardial infarction,as well as its association with the left ventricular remodeling and prognosis.Methods： In the study,61 patients with acute ST-segment elevation myocardial infarction were recruited.Blood samples were taken at admission,on the 3rd day and 7th day of admission,while 63 healthy blood donors were employed as normal controls.There plasma osteopontin levels were measured by ELSIA.Results： Compared with the normal controls,the plasma osteopontin levels of the patients with acute ST-segment elevation myocardial infarction were significantly higher at admission [（96.51±37.22） μg/L vs.（54.50±28.17） μg/L,P＆lt;0.001],reached the peak value on the 3rd day,and dropped down on the 7th day.The correlation analysis showed that the plasma osteopontin level positively correlated with age and left ventricular end-systolic volume index 3 months after acute myocardial infarction,and negatively correlated with left ventricular ejection fraction 3 months after acute myocardial infarction.The follow-up study found that the plasma osteopontin level did not predict mortality,re-infarction,stroke,revascularization or hospitalization due to heart failure.Conclusion： In patients with acute ST-segment elevation myocardial infarction,the elevated plasma level of osteopontin might be associated with the left ventricular remodeling.

关 键 词：骨桥蛋白质 心肌梗死 心室重构 

分 类 号：R542.22[医药卫生—心血管疾病]