PCI术后内皮微粒水平动态变化与AMI类型的关联性及其临床意义  

Changes of peripheral blood plasma endothelium particles in myocardial infarction after reperfusion

作　　者：谢倩倩[1] 朱建兵[1] 韦小未 周瑶瑶[1] 张田田[1] 张俊峰[1] 

机构地区：[1]上海交通大学医学院附属第三人民医院心内科,上海201999

出　　处：《心脏杂志》2015年第1期16-19,共4页Chinese Heart Journal

基　　金：上海市自然科学基金项目资助(12ZR1417400);上海市宝山区科委项目资助(10-E-4)

摘　　要：目的:探讨外周血血浆内皮微粒(EMP)与冠状动脉介入术(PCI)再灌注损伤的关系。方法:入选45例急性心肌梗死(AMI)患者,其中急性ST抬高型心肌梗死(STEMI)35例,急性非抬高型心肌梗死(NSTEMI)10例,STEMI组患者发病12 h内及早予直接PCI治疗,仅处理"罪犯"血管。NSTEMI组患者予早期(48 h)冠脉造影及PCI治疗。所有患者均选择雷帕霉素药物洗脱支架。观察两组患者术前后血浆EMP表达变化,分析EMP与心肌再灌注损伤的相关性。结果:1STEMI和NSTEMI两组患者行PCI治疗后EMP表达均增高。2STEMI患者行再灌注治疗术后1 h EMP即大幅增高,峰值明显早且大于NSTEMI PCI组,与CK-MB增长趋势一致,两组比较(P<0.05),差异有统计学意义(P<0.05)。结论:PCI术后血浆EMP水平的动态变化与AMI类型有关。AIM： To investigate the correlation between peripheral blood plasma endothelium particles （EMP） and reperfusion injury in patients with ST-elevated myocardial infarction （STEMI） or non-ST- elevated myocardial infarction （NSTEMI）. METHODS ： A total of 45 patients with myocardial infarction were eligible for this study, including STEMI patients （ n = 35 ） and NSTEMI patients （ n = 10）. STEMI patients received primary PCI in the ＂infarct-related artery＂ within 12 h and NSTEMI patients received selective PCI within 48 h, respectively. Sirolimus-eluting stents were used in all patients. Changes in concentrations of plasma EMP were detected using flow cytometer assay and the correlation between EMP and myocardial reperfusion injury was assessed. RESULTS： EMP increased markedly in both STEM1 and NSTEMI patients receiving PCI. At 1 h after PCI, the elevation in the peak of plasma EMP in STEMI patients was more noticeable than in NSTEMI patients （P 〈 0. 05 ）. Such a result was also detected in the increase of CKMB. CONCLUSION： The dynamic changes of EMP in plasma after PCI are related to the different types of acute myocardial infarction.

关 键 词：内皮微粒 急性心肌梗死 再灌注损伤 冠状动脉介入术 

分 类 号：R541.4[医药卫生—心血管疾病]