初诊急性心肌梗死患者血浆FGF-21水平及临床意义  

The plasma levels of FGF-21 in patients with acute myocardial infarction by preliminary diagnosis and its clinical significance

作　　者：孙小蒙[1] 张恒[1] 范慧[1] 王广[1] 

机构地区：[1]首都医科大学附属北京朝阳医院内分泌科,北京市100020

出　　处：《河北医药》2017年第17期2569-2572,共4页Hebei Medical Journal

基　　金：国家自然科学基金项目(编号:81270369);北京市自然科学基金项目(编号:7142060)

摘　　要：目的探讨初诊急性心肌梗死患者血浆成纤维细胞生长因子21(FGF-21)水平及其与血糖、血脂以及心肌梗死事件的关系。方法应用ELISA方法测定初诊55例急性心肌梗死患者(急性心肌梗死组)及正常人52例(正常对照组)的血浆FGF-21水平,比较不同人群血浆FGF-21水平,分析初诊急性心肌梗死患者血浆FGF-21水平与体重指数(BMI)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、尿素氮(BUN)、血肌酐(SCr)、SUA(血尿酸)、血脂[三酰甘油(TG)、高敏C-反应蛋白(Hs-CRP)、门冬氨酸转移酶(AST)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)]以及急性心肌梗死事件等的关系。结果急性心肌梗死伴有2型糖尿病组BMI、TG、BUN、SCr、SUA、Hs-CRP、AST、FBG、HbA1c、FGF-21均高于正常对照组,TC、HDL-C、LDL-C均低于正常对照组,差异均有统计学意义(P<0.05)。急性心肌梗死未伴有2型糖尿病组BUN、SCr、SUA、AST、FBG、HbA1c、FGF-21均高于正常对照组,TC、HDL-C、LDL-C均低于正常对照组,差异均有统计学意义(P<0.05)。急性心肌梗死伴有2型糖尿病组年龄、BUN、SCr、FBG、HbA1c、BNP、CKMB均高于急性心肌梗死未伴有2型糖尿病组,差异均有统计学意义(P<0.05)。初诊急性心肌梗死患者患者FGF-21水平与TG呈正相关(r=0.627,P=0.000)。健康人群中,血浆FGF-21水平与TG呈正相关(r=0.318,P=0.0016)。多元Logistic回归显示,年龄、HbA1c、FGF-21是的急性心肌梗死的独立危险因素。结论心肌缺血而引起心肌损伤时,患者血浆FGF-21存在代偿性的分泌量增加,可能在心肌保护过程中起了作用。Objective To observe the changes of plasma levels of fibroblast growth factor 21（FGF-21） in newly diagnosed acute myocardial infarction （AMI） patients, and to explore the correlation between its levels and plasma glucose,blood lipoids as well as AMI events.Methods The plasma levels of FGF-21 were detected by ELlSA in 55 cases of AMI （AMI group） and 52 healthy subjects （control group）,and the correlation between the plasma levels of FGF-21 in newly diagnosed AMI patients and BMI,FBG,HbA1c,BUN,SCr,SUA,TG,Hs-CRP,AST,HDL-C,LDL-C,AMI events was evaluated by multivariate logistic regression analysis.Results The levels of BMI,TG,BUN,SCr,SUA,Hs-CRP,AST,FBG,HbA1c,FGF-21in AMI with type 2 diabetes group were significantly higher than those in control group,however, the levels of TC,HDL-C,LDL-C were significantly lower than those in control group （P〈0.05）.Moreover the levels of BUN,SCr,SUA, AST,FBG,HbA1c,FGF-21 in AMI without diabetes group were significantly higher than those in control group,however, the levels of TC,HDL-C,LDL-C were significantly lower than those in control group （P〈0.05）.The patient＆#39;s age,the levels of BUN,SCr,FBG,HbA1c, BNP,CKMB in AMI with type 2 diabetes group were significantly higher than those in AMI without diabetes group （P〈0.05）.The levels of FGF-21 in first diagnosed AMI patients were positively correlated with those of TG （r=0.627,P〈0.01）.In healthy subjects,the plasma levels of FGF-21 were positively correlated with those of TG （r=0.318,P〈0.01）.The multivariant Logistic regression showed that patient＆#39;s age, HbA1C,FGF-21 were independent risk factors of AMI.Conclusion The plasma levels of FGF-21 are compensationally increased when myocardial ischemia results in myocardial damage,which may play an important role during myocardial preservation.

关 键 词：心肌梗死 急性 成纤维细胞生长因子-21 2型糖尿病 

分 类 号：R542.22[医药卫生—心血管疾病]