血清多种生化指标在PCI患者围术期的浓度变化  

Perioperative Changes of Serum Biochemical Markers in Patients with PCI

作　　者：秦绪珍[1] 王丹晨 叶益聪[2] 唐国栋[3] 侯立安[1] 刘荔[1] 鲁军 尤婷婷 李洪磊 邱玲[1] QIN Xu-zhen;WANG Dan-chen;YE Yi-cong;TANG Guo-dong;HOU Li-an;LIU Li;LU Jun;YOU Ting-ting;LI Hong-lei;QIU Ling(a. Department of Laboratory Medicine;1b. Department of Cardiology ,Peking Union Medical College Hospital, Chinese Academic Medical Science and Peking Union Medical College ,Beijing 100730,Chin;2. Department of Cardiology ,Beijing Hospital ,Beijing 100730 ,China)

机构地区：[1]中国医学科学院北京协和医院检验科,北京100730 [2]中国医学科学院北京协和医院心内科,北京100730 [3]北京医院心内科,北京100730

出　　处：《现代检验医学杂志》2018年第1期35-39,共5页Journal of Modern Laboratory Medicine

基　　金：863计划心脑血管慢性损伤及急救指标等体外诊断试剂的研制(2011AA02A111)

摘　　要：目的探讨经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)患者心型脂肪酸结合蛋白(heart-type fatty acid-binding protein,h-FABP)、缺血修饰清蛋白(ischemia modified albumin,IMA)、白细胞介素-2受体(interleukin-2receptor,IL-2R)、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-8(interleukin-8,IL-8)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、髓过氧化物酶(myeloperoxidase,MPO)等指标在术后24h内的变化规律。方法收集2011年11月~2012年2月北京协和医院心内监护室实施PCI术后34例患者2,4,8和24h血清标本,分别检测IL-2R,IL-6,IL-8,TNF-α,h-FABP,IMA和MPO血清浓度。结果 MPO,h-FABP和CKMB浓度在PCI术后2h已明显升高(2h与24h比较,Z值分别为-3.621,-5.123,-2.789,均P<0.05),h-FABP浓度在24h内快速降到正常范围内,MPO浓度在4h后明显降低,CKMB浓度在4h达峰值,然后迅速降低;CK,cTnI浓度在PCI术后4h升高(4h和24h比较,Z值分别为-2.803,-2.31,均P<0.05),8h达峰值后逐渐降低。Spearman相关分析cTnI与CKMB,CK相关系数大于0.6以上。结论研究发现PCI术后多种生化标志物的变化规律,为临床诊治提供依据。Objective To evaluate the perioperative changes of h-FABP,IMA,IL-2 R,IL-6,IL-8,TNF-αand MPO in patients with PCI.Methods The serial serum samples from 34 patients were collected from November of 2011 to February of 2012 in coronary care unit of Peking Union Hospital on separately 2,4,8 and 24 hours after PCI,then IL2 R,IL6,IL8,TNF-α,hFABP,IMA and MPO were measured.Results MPO,h-FABP and CKMB increased dramatically at 2 hours after PCI（Z value were separately-3.621,-5.123 and-2.789 compared with the level at 2 hand 24 h,all P〈0.05）,and h-FABP within 24 hours fell into the normal range.MPO dropped quickly after 4 hours of surgery and CKMB peaked at 4 hours,then decreased.The concentration of CK and cTnI rose up at 4 h（Z value were separately-2.803 and-2.31 compared with the level at 2 hand 24 h,all P〈0.05）and declined with a climax at 8 hafter PCI.The correlation coefficient of CKMB and CK with cTnI were higher than 0.6.Conclusion This study provided an overview of the change of multi-biomarkers following PCI,which gave a valuable information for clinical treatment.

关 键 词：经皮冠状动脉介入术 心型脂肪酸结合蛋白 缺血修饰清蛋白 白细胞介素 肿瘤坏死因子 髓过氧化物酶 

分 类 号：R616[医药卫生—外科学] R446.112[医药卫生—临床医学]