急性心肌梗死患者PCI术后心室重构患者血清Hcy、CysC、MMP-1、NGAL的表达及临床意义  

Expression and Clinical Significance of Serum Hcy, CysC, MMP-1 and NGAL in Patients with Acute Myocardial Infarction after PCI

作　　者：杨蓉[1] 胡峥 刘栋 李怡帆 郭瑞雪 刘裴[2] YANG Rong;HU Zheng;LIU Dong;LI Yi-fan;GUO Rui-xue;LIU Pei(Department of Internal Medicine-Cardiovascular,The Second Hospital of Hebei Medical University,Shijiazhuang,Hebei,050005,China;Department of Ultrasonography,Hengshui Fourth People's Hospital,Hengshui,Hebei,053000,China)

机构地区：[1]河北医科大学第二医院心内科,河北石家庄050005 [2]衡水市第四人民医院超声科,河北衡水053000

出　　处：《现代生物医学进展》2021年第18期3524-3528,共5页Progress in Modern Biomedicine

基　　金：河北省卫计委重点科技研究计划项目(20190557)。

摘　　要：目的:观察急性心肌梗死(AMI)患者经皮冠脉介入术(PCI)术后心室重构患者血清同型半胱氨酸(Hcy)、胱抑素C(Cys C)、基质金属蛋白酶-1(MMP-1)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)的表达及临床意义。方法:选取2018年3月~2020年9月期间我院收治的AMI患者70例。根据PCI术后是否发生心室重构将其分为无心室重构组(n=49)和心室重构组(n=21)。检测患者血清MMP-1、Hcy、NGAL、Cys C水平及心功能指标[左室后壁厚度(LVPWT)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、室间隔厚度(IVST)]。分析血清MMP-1、Hcy、NGAL、Cys C水平与心功能指标的相关性。分析AMI患者PCI术后心室重构的影响因素。结果:心室重构组血清MMP-1、Hcy、NGAL、Cys C水平均高于无心室重构组(P<0.05);LVEDD、IVST、LVPWT均大于无心室重构组,LVEF低于无心室重构组(P<0.05)。Pearson相关性分析结果显示:血清MMP-1、Hcy、NGAL、Cys C水平和LVEDD、IVST、LVPWT均呈正相关,而与LVEF呈负相关(P<0.05)。单因素分析结果显示:两组患者梗死部位、心律失常情况、单核细胞(MO)、肌酸激酶同功酶(CK-MB)、发病到开通梗死相关动脉时间组间对比差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示:梗死部位为前壁、发生心律失常以及高水平的MO、CK-MB、MMP-1、Hcy、Cys C均是AMI患者PCI术后发生心室重构的危险因素(P<0.05)。结论:血清MMP-1、Hcy、NGAL、Cys C表达均与AMI患者PCI术后的心室重构密切相关,检测以上指标水平可对AMI患者PCI术后心室重构的预测和防治提供一定参考。Objective:To observe the expression and clinical significance of serum homocysteine(Hcy),Cystatin C(Cys C),matrix metalloproteinase-1(MMP-1),neutrophil gelatinase related lipid delivery protein(NGAL)in patients with acute myocardial infarction(AMI)after PCI.Methods:70 patients with AMI in our hospital were selected from March 2018 to September 2020.According to whether ventricular remodeling occurred after PCI,they were divided into no ventricular remodeling group(n=49)and ventricular remodeling group(n=21).The serum MMP-1,Hcy,NGAL,Cys C levels and cardiac function indexes[left ventricular posterior wall thickness(LVPWT),left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),ventricular septal thickness(IVST)]of patients were detected.The correlation between serum MMP-1,Hcy,NGAL and Cys C levels and cardiac function indexes were analyzed.The influencing factors of ventricular remodeling after PCI in patients with AMI were analyzed.Results:The serum MMP-1,Hcy,NGAL and Cys C levels in the ventricular remodeling group were higher than those in the no ventricular remodeling group(P<0.05),while LVEDD,IVST and LVPWT were all greater than those in the no ventricular remodeling group,and LVEF was smaller than that in the no ventricular remodeling group(P<0.05).Pearson correlation analysis results showed that serum MMP-1,Hcy,NGAL,Cys C levels were positively correlated with LVEDD,IVST and LVPWT,but negatively correlated with LVEF(P<0.05).Univariate analysis showed that there were statistically significant differences in infarct site,arrhythmia,monocyte(MO),creatine kinase isoenzyme(CK-MB),and time from onset to opening of infarct-related artery between the two groups(P<0.05).Multivariate Logistic regression analysis showed that anterior wall infarction site,arrhythmia occurs and high levels of MO,CK-MB,MMP-1,Hcy and Cys C were all risk factors for ventricular remodeling after PCI in patients with AMI(P<0.05).Conclusion:The serum expressions of MMP-1,Hcy,NGAL and Cys C are closely related t

关 键 词：急性心肌梗死 经皮冠脉介入术 心室重构 HCY Cys C MMP-1 NGAL 

分 类 号：R541.4[医药卫生—心血管疾病]