急性前壁心肌梗死患者PCI后血清CTGF、BNP、左心室功能指标的变化及其关系分析  

Serum levels of connective tissue growth factor and brain natriuretic peptide level and left ventricular function in patients with acute anterior wall myocardial infarction undergoing percutaneous coronary intervention

作　　者：张莉[1] 陈长弓 刘东红[2] 顾兴建[1] 任诗佳 陈自力[1] 郑继平[1] 

机构地区：[1]台州市第一人民医院心内科,318020 [2]台州市第一人民医院检验科,318020

出　　处：《浙江医学》2016年第22期1822-1825,共4页Zhejiang Medical Journal

基　　金：台州市黄岩区科技计划项目(2014054-3)

摘　　要：目的探讨急性前壁心肌梗死患者经皮冠状动脉介入(PCI)术后血清结缔组织生长因子(CTGF)浓度与血清B型脑钠肽(BNP)浓度、左心室功能的变化及其关系。方法选择急性前壁心肌梗死患者100例,胸闷、胸痛发作12h内成功行PCI术者54例为急诊PCI组,急诊PCI失败、未行急诊PCI者46例为非急诊PCI组。患者随访至少半年及以上。采用ELISA法测定患者血清CTGF浓度,化学发光法测定血清BNP浓度,用超声心动图测定两组患者左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)。结果非急诊PCI组血清CTGF浓度、BNP浓度、LVEDV、LVESV均明显低于急诊PCI组(均P<0.01),而LVEF在急诊PCI组明显高于非急诊PCI组(P<0.01)。血清CTGF浓度与BNP、LVEDV、LVESV均呈正相关(r=0.418、0.598、0.44,均P<0.01),与LVEF呈负相关(r=-0.567,P<0.01)。结论急性前壁心肌梗死患者早期成功行PCI术可明显降低血清CTGF浓度,并改善急性心肌梗死患者的心脏功能,血清CTGF可能是心脏重塑血清标记物之一。Objective To investigate the serum levels of connective tissue growth factor（CTGF） and brain natriuretic peptide（BNP） and left ventricular function in patients with acute anterior myocardial infarction（AAMI） undergoing percutaneous coronary intervention（PCI）.Methods One hundred patients with AAMI were included in the study,including 54 cases successfully undergoing PCI within 12 h after onset of chest distress and chest pain（emergency PCI group）,and 46 cases with failed emergency PCI or no emergency PCI（non-emergency PCI group）.Patients were followed up for at least 6 months in our hospital.Serum CTGF and BNP levels were measured by ELISA and chemiluminescence methods respectively,left ventricular function,including left ventricular end diastolic volume（LVEDV）,left ventricular end systolic volume（LVESV） and left ventricular ejection fraction（LVEF） was determined by ultrasonic echocardiography.Results Serum CTGF,serum BNP,LVEDVand LVESV in emergency PCI group were significantly lower than those in non-emergency PCI group（all P 0.01）,while LVEF in the emergency PCI group was significantly higher than in that in non emergency PCI group（P 〈0.01）.Serum levels of CTGF and serum levels of BNP,LVEDV,LVESV were positively correlated with each other（7=0.418,0.598,0.44,allP〈0.01）,and negatively correlated with LVEF（r=-0.567,P〈0.01）.Conclusion PCI can significantly reduce serum CTGF levels and improve cardiac function in patients with acute myocardial infarction.Serum CTGF may be one of the markers of cardiac remodeling in patients with acute myocardial infarction.

关 键 词：结缔组织生长因子 急性前壁心肌梗死 经皮冠状动脉介入术 心脏重塑 

分 类 号：R542.22[医药卫生—心血管疾病]