血清间质胶原动态变化预测急性心肌梗死心室重构的意义  

Collagen dynamic changes monitored ventricular remodeling in patients with acute myocardial infarction

作　　者：许兆延[1] 王雪珍[1] 杨希立[1] 

机构地区：[1]佛山市第一人民医院心血管内科,广东佛山528000

出　　处：《临床心血管病杂志》2015年第11期1178-1181,共4页Journal of Clinical Cardiology

摘　　要：目的:探讨动态监测血清间质胶原浓度预测急性心肌梗死患者左心重构的意义。方法:随机初选急性心肌梗死患者共70例,采用随机对照的方法,分为急诊经皮冠脉介入术组(31例)和择期介入术组(29例)。所有患者在术前、起病后30d及起病后90d均分别以酶联免疫法测定血清Ⅰ型C端胶原前肽、Ⅰ型C端胶原末肽和Ⅲ型N端胶原前肽;均行超声心动图检查,测量左室收缩、舒张末期内径,左心室射血分数;行单光子发射计算机断层显像检查,测量心肌梗死面积,计算左心室射血分数。结果:急诊组术前、起病后30d、起病后90d血清胶原均低于择期组。超声心动图提示急诊组起病后90d左室舒张末径小于择期组。单光子发射计算机断层显像检查提示起病后30d和90d急诊组梗死面积小于择期组,射血分数高于择期组。结论:急性心肌梗死患者急诊介入手术可使血清胶原浓度降低,缩小梗死面积,改善心室功能。通过动态检查胶原含量,可用于预测急性心肌梗死患者预后。Objective：To explore the predicting value of serum collagen concentration on ventricular remodeling in patients with acute myocardial infarction（AMI）.Method：The 70 patients with AMI were divided into 2 groups,primary percutaneous coronary intervention（PCI）group and selection PCI group.All patients were detected carboxyterminal of type I procollagen（PICP）,carboxy-terminal telopeptide of collagen type I（CITP）and amino-terminal propeptide of typeⅢ procollagen（PⅢNP）on the day before PCI procedure,on-set 30 days later and on-set 90 days later.All patients were examined echocardiogram and single photon emission computed tomography（SPECT）of heart,and myocardial infarction size（MIS）and LVEF were measured.Result：The collagen concentration in primary PCI group were decreased significantly compared with selection PCI group.On the 90 th on-set day,LVEDD were decreased in primary PCI group compared with selection PCI group.According to the SPECT result,on the 30 th or 90 th on-set day,MIS were decreased and EF increased in primary PCI group compared with selection PCI group.Conclusion：The collagen concentration and MIS decreased and heart function improved in primary PCI post AMI.Dynamic detecting collagen could predict ventricular remodeling after AMI.

关 键 词：急性心肌梗死 胶原 急诊经皮冠脉介入术 心室重构 

分 类 号：R542.2[医药卫生—心血管疾病]