急性心肌梗死患者血清IGFBP-6、TGF-β_(1)水平变化及与冠状动脉病变程度和预后的关系  

Changes of serum IGFBP-6 and TGF-β_(1) levels in patients with acute myocardial infarction and their relationship with the degree of coronary artery lesion and prognosis

作　　者：彭伟 刘畅[2] 李勇[1] 史玉芳 江蓉 黄薇隗 向常清[1] 郑永强 PENG Wei;LIU Chang;LI Yong;SHI Yufang;JIANG Rong;HUANG Weiwei;XIANG Changqing;ZHENG Yongqiang(Department of Emergency,Yichang Second People′s Hospital/the Second People′s Hospital of China Three Gorges University,Yichang,Hubei 443000,China;Department of Functional Medicine,Renhe Hospital,China Three Gorges University,Yichang,Hubei 443000,China;Department of Cardiovascular Medicine,Yichang Second People′s Hospital/the Second People′s Hospital of China Three Gorges University,Yichang,Hubei 443000,China;Department of Neurology,Yichang Second People′s Hospital/the Second People′s Hospital of China Three Gorges University,Yichang,Hubei 443000,China)

机构地区：[1]湖北省宜昌市第二人民医院/三峡大学第二人民医院急诊内科,湖北宜昌443000 [2]三峡大学仁和医院功能科,湖北宜昌443000 [3]湖北省宜昌市第二人民医院/三峡大学第二人民医院心血管内科,湖北宜昌443000 [4]湖北省宜昌市第二人民医院/三峡大学第二人民医院神经内科,湖北宜昌443000

出　　处：《检验医学与临床》2022年第16期2185-2188,共4页Laboratory Medicine and Clinic

基　　金：湖北省卫生健康委员会科研项目(WJ2019M065)。

摘　　要：目的探讨急性心肌梗死(AMI)患者血清胰岛素样生长因子结合蛋白-6(IGFBP-6)、转化生长因子β_(1)(TGF-β_(1))的水平变化及其与冠状动脉病变程度和预后的关系。方法选取2018年2月至2019年2月于湖北省宜昌市第二人民医院心内科就诊的180例AMI患者为AMI组,根据Gensini评分将AMI组患者分为低Gensini评分(LGS)组(<27分)59例,中Gensini评分(MGS)组(27~38分)52例和高Gensini评分(HGS)组(>38分)69例。选取同期体检健康者50例为对照组。比较对照组与AMI组,以及不同冠状动脉病变程度组血清IGFBP-6、TGF-β_(1)水平。分析AMI患者血清IGFBP-6、TGF-β_(1)水平间的相关性。比较AMI患者IGFBP-6高表达组和低表达组、TGF-β_(1)高表达组和低表达组30 d内不良预后情况。结果与对照组比较,AMI组患者血清IGFBP-6水平明显升高,TGF-β_(1)水平明显降低,差异有统计学意义(P<0.05)。与LGS组比较,MGS组、HGS组患者血清IGFBP-6水平升高,TGF-β_(1)水平降低,差异有统计学意义(P<0.05);与MGS组比较,HGS组患者血清IGFBP-6水平升高,TGF-β_(1)水平降低,差异有统计学意义(P<0.05)。AMI患者血清IGFBP-6水平与TGF-β_(1)水平呈负相关(r=-0.642,P<0.05)。IGFBP-6高表达组患者死亡、再次心肌梗死、心源性休克、致死性心律失常发生率高于IGFBP-6低表达组,差异有统计学意义(P<0.05)。TGF-β_(1)高表达组患者死亡、再次心肌梗死、心源性休克、致死性心律失常发生率低于TGF-β_(1)低表达组,差异有统计学意义(P<0.05)。结论AMI患者血清IGFBP-6、TGF-β_(1)水平与冠状动脉病变程度有关,且二者还可作为评估AMI患者预后的参考指标。Objective To investigate the changes of serum insulin-like growth factor-binding protein-6(IGFBP-6)and transforming growth factorβ_(1)(TGF-β_(1))levels in patients with acute myocardial infarction(AMI)and their relationship with the degree of coronary artery lesion and prognosis.Methods A total of 180 AMI patients who were treated in the Department of Cardiovascular Medicine of Yichang Second People′s Hospital from February 2018 to February 2019 were selected as the AMI group.According to the Gensini score,the patients in the AMI group were divided into the low Gensini score(LGS)group(<27 points)with 59 cases,the middle Gensini score(MGS)group(27—38 points)with 52 cases and the high Gensini score(HGS)group(>38 points)with 69 cases.A total of 50 healthy subjects who underwent physical examination during the same period were selected as the control group.The serum levels of IGFBP-6 and TGF-β_(1) were compared between the control group and the AMI group,as well as the groups with different degrees of coronary artery lesion.The correlation between serum IGFBP-6 and TGF-β_(1) levels in AMI patients was analyzed.The poor prognosis within 30 d of IGFBP-6 high expression group and low expression group,and TGF-β_(1) high expression group and low expression group in AMI patients were compared.Results Compared with the control group,the serum IGFBP-6 level in the AMI group was significantly increased,and the serum TGF-β_(1) level was significantly decreased,and the differences were statistically significant(P<0.05).Compared with the LGS group,the serum IGFBP-6 level in the MGS group and the HGS group was increased,and the serum TGF-β_(1) level was decreased,and the differences were statistically significant(P<0.05).Compared with the MGS group,the serum IGFBP-6 level in the HGS group was increased,and the serum TGF-β_(1) level was decreased,and the differences were statistically significant(P<0.05).The level of serum IGFBP-6 in AMI patients was negatively correlated with the level of serum TGF-β_(1)(r=-0.642,P<0

关 键 词：急性心肌梗死 胰岛素样生长因子结合蛋白-6 转化生长因子Β1 冠状动脉粥样硬化 

分 类 号：R541.4[医药卫生—心血管疾病]