分泌性磷脂酶A2在STEMI再灌注损伤及愈后中的预测价值  

Predictive value of secretory phospholipase A2 in STEMI reperfusion injury and prognosis

作　　者：陈月婷[1] 张振[1] 李卫娜[1] 

机构地区：[1]涿州市医院心内科,河北涿州072750

出　　处：《西南国防医药》2016年第9期963-966,共4页Medical Journal of National Defending Forces in Southwest China

基　　金：保定市科学技术局科技支撑计划项目(14ZF086)

摘　　要：目的研究分泌性磷脂酶A2(Lp-PLA2)在ST段抬高型急性心肌梗死行经皮冠状动脉介入治疗(PCI)后发生再灌注损伤及愈后判断中的预测价值。方法收集我科住院治疗的急性心梗患者90例,根据PCI术前Lp-PLA2中位值将患者分为高水平组和低水平组,比较两组基础临床资料、冠脉病变支数以及冠脉血流情况。结果两组在性别、年龄、体质数、肌酐、尿素氮和左室射血分数等指标方面比较均无统计学差异(P>0.05);高水平组单支或双支血管病变数明显少于低水平组,三支血管或左主干病变患者明显多于低水平组;高水平组TIMI血流帧数明显高于低水平组,TIMI心肌灌注分级0~2级患者数明显多于低水平组(P<0.05);高水平组远期心脏不良事件发生率明显高于低水平组(P<0.05)。结论 Lp-PLA2水平高低与冠脉病变支数、PCI术后心肌灌注不良风险高低及心血管事件再发生率密切相关。Objective To study the predictive value of secretory phospholipase A2 （Lp-PLA2） in reperfusion injury after percutaneous coronary intervention （PCI） for ST elevation acute myocardial infarction （AMI） and prognosis, Methods A total of 90 cases of AMI patients admitted to our department were selected and divided into a high level group and a low level group according to the Lp-PLA2 median before PCI to compare the basic clinical data, number of diseased coronary artery and coronary blood flow in the two groups, ll^gtdlg There was no statistical difference in gender, age, weight, creatinine, urea nitrogen, LVEF and other indicators between the two groups （P 〉 0.05）; the number of single or double diseased coronary artery （arteries） in the high level group was fewer than that in the low level group; the number of patients with three diseased coronary arteries or left main coronary artery was fewer than that in the low level group; the TIMI frame count in the high level group was much higher than that in the low level group; the number of patients at TIMI myocardial perfusion grades 0-2 was more than that in the low level group （P 〈 0.05）; the incidence of long-term cardiac adverse events in the high level group was significantly higher than that in the low level group （P 〈 0.05）. Conclusion The level of Lp-PLA2 is closely related to the number of diseased coronary artery, the risk of poor myocardial perfusion after PCI and the recurrence rate of cardiovascular events.

关 键 词：分泌性磷脂酶A2 心肌梗死 介入治疗 再灌注损伤 心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]