血清血管内皮生长因子B检测在急性心肌梗死患者预后评判中的作用  

Effects of Serum Vascular Endothelial Growth Factor-B Measurement in the Prognosis Evaluation of Patients with Acute Myocardial Infarction

作　　者：顾遵才[1] 李勋[2] 王正忠[1] 赵思源[1] 曹荣元[1] 孙黎明[1] 

机构地区：[1]连云港市第二人民医院心血管内科,江苏省连云港市222000 [2]苏州大学附属第一医院心血管内科,江苏省苏州市215006

出　　处：《中国动脉硬化杂志》2016年第6期611-614,共4页Chinese Journal of Arteriosclerosis

摘　　要：目的探讨血清血管内皮生长因子B(VEGF-B)在急性心肌梗死(AMI)患者预后评判中的价值。方法选择2014年3月至2015年10月收治的AMI患者62例作为病例组,于出院前抽肘静脉血采用双抗体夹心酶联免疫吸附试验(ELISA)法测定血清VEGF-B浓度。随访AMI患者出院后60天与出院前左心室舒张期末容积(LVEDV)和左心室心肌质量(LVM)的增加值(ΔEDV和ΔM)及出院后60天内主要不良心脏事件(MACE)的发生情况,根据ΔEDV水平将患者分为ΔEDV≤0组及ΔEDV>0组,根据ΔM水平将患者分为ΔM≤0组及ΔM>0组,根据是否发生MACE将患者分为MACE组及无MACE组,分析出院前VEGF-B浓度对出院后左心室重构(LVR)及发生MACE的预测价值,分析AMI组患者出院后MACE与LVR的关系。结果随访结果显示,ΔEDV≤0组血清VEGFB浓度[(110.61±38.29)μg/L,n=34]显著高于ΔEDV>0组[(67.74±24.32)μg/L,n=26];ΔM≤0组血清VEGFB浓度[(112.46±39.91)μg/L,n=32]明显高于ΔM>0组[(70.24±23.17)μg/L,n=28];MACE组血清VEGF-B浓度[(53.73±15.70)μg/L,n=25]显著低于无MACE组[(111.95±33.16)μg/L,n=37],差异均有统计学意义(P<0.01)。LVR组MACE发生率(100%)较无LVR组(5.26%)明显升高(P<0.01)。结论 AMI患者出院前血清VEGF-B浓度越低,出院后LVR越明显,低浓度VEGF-B预示AMI后易发生LVR。AMI患者出院前血清VEGF-B浓度越低,出院后MACE发生率越高,出院前血清VEGF-B浓度可以作为出院后MACE发生的预测指标。Aim To investigate the value of serum vascular endothelial growth factor-B（VEGF-B）in the prognosis evaluation of patients with acute myocardial infarction（AMI）. Methods Sixty-two patients with AMI were selected as case group in the department of cardiology from March 2014 to October 2015,and the elbow venous blood of AMI patients were immediately drawn before discharge,and enzyme-linked immunosorbent assay（ELISA）method was used for determining the concentrations of serum VEGF-B. The increased values（ΔEDV,ΔM）of the left ventricular end diastolic volume（LVEDV）,left ventricular mass（LVM）and the occurrence of major adverse cardiac events（MACE）of the AMI patients were followed up within sixty days after discharge. The AMI patients were divided into ΔEDV ≤0 group andΔEDV0 group,ΔM≤0 group and ΔM0 group respectively according to the ΔEDV level and ΔM level. According to MACE occurrence,the AMI patients were divided into the MACE group and non-MACE group. The predictive value of VEGF-B concentration before discharge was analysed to left ventricular remodeling（LVR）and MACE after discharge.The relationship between MACE and LVR in AMI patients after discharge was also analysed. Results According to the results of the follow-up,the concentration of serum VEGF-B of ΔEDV≤0 group（（110. 61±38. 29）μg / L,n = 34）was significantly higher than that of ΔEDV0 group（（67. 74±24. 32）μg / L,n = 26）,the concentration of serum VEGF-B ofΔM≤0 group（（112. 46±39. 91）μg / L,n = 32）was significantly higher than that of ΔM0 group（（70. 24±23. 17）μg /L,n = 28）,the concentration of serum VEGF-B of the MACE group（（53. 73 ±15. 70）μg / L,n = 25）was significantly lower than that of non-MACE group（（111. 95±33. 16）μg / L,n = 37）,the differences were statistically significant（P〈0.01）. The incidence of MACE in LVR group（100%）was higher than that of non-LVR group（5. 26%）,the difference was statistically significant（P〈0. 01）. Conc

关 键 词：急性心肌梗死 血管内皮生长因子B 主要不良心脏事件 左心室重构 

分 类 号：R5[医药卫生—内科学]