STEMI患者行急诊PCI和肢体远隔缺血适应后血清SDF-1α变化及其与心室重构的关系  

Changes in serum SDF-1α level in patients with STEMI after PCI and limb remote ischemic conditioning and its association with ventricular remodeling

作　　者：蒋梦 邢玉龙 陈鑫 王文彬 JIANG Meng;XING Yulong;CHEN Xin;WANG Wenbin(Department of Cardiology,Nanjing Gaochun People's Hospital,Nanjing 211300,China)

机构地区：[1]南京市高淳人民医院心血管内科,211300

出　　处：《心电与循环》2024年第4期349-353,共5页Journal of Electrocardiology and Circulation

摘　　要：目的 探讨急性ST段抬高心肌梗死(STEMI)患者行急诊经皮冠状动脉介入治疗(PCI)和肢体远隔缺血适应(RIC)后血清基质细胞衍生因子1α(SDF-1α)变化及其与心室重构的关系。方法 回顾性选取2020年1月至2022年7月在南京市高淳人民医院行急诊PCI的70例STEMI患者为研究对象,其中行PCI+RIC(RIC组)37例,仅行PCI(对照组)33例;比较两组患者手术前后血清SDF-1α浓度、术后3 d及1年心功能指标[包括左心室射血分数(LVEF)、左心室舒张末期内径(LVEDd)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)]及校正心肌梗死溶栓试验帧数(CTFC);采用Pearson相关分析术后即刻血清SDF-1α浓度与术后1年心功能指标的相关性。结果 两组患者术后血清SDF-1α浓度均较术前明显增加,且RIC组高于对照组,差异均有统计学意义(均P<0.05)。RIC组CTFC明显低于对照组(P=0.005)。RIC组术后3 d的LVEF高于对照组(P=0.038),但术后3 d的LVEDd、LVEDV、LVESV及术后1年LVEF、LVEDd、LVEDV、LVESV比较,差异均无统计学意义(均P>0.05)。术后即刻血清SDF-1α浓度与术后1年LVEDd、LVEDV、LVESV均呈负相关(r=-0.338、-0.296、-0.314,均P<0.05)。结论 STEMI患者行PCI和RIC后血清SDF-1α浓度明显升高,且与心室重构改善有关。Objective To investigate the changes in serum stromal cell-derived factor-1α(SDF-1α) in patients with ST-segment elevation myocardial infarction(STEMI) after percutaneous coronary intervention(PCI) and limb remote ischemic conditioning(RIC) and its association with ventricular remodeling. Methods A retrospective study was conducted on 70 patients with STEMI who underwent emergency PCI in Nanjing Gaochun People's Hospital from January 2020 to July 2022. Among them, 37 patients received PCI+RIC(RIC group) and 33 patients only recived PCI(control group). Serum SDF-1α concentration before and after PCI, cardiac function [Including left ventricular ejection fraction(LVEF), left ventricular end-diastolic dimension(LVEDd), left ventricular end-diastolic volume(LVEDV), left ventricular end-systolic volume(LVESV)] at 3 days and 1 year after PCI and corrected thrombolysis in myocardial infarction frame count(CTFC) between the two groups were compared. Pearson correlation was used to analyze the correlation between serum SDF-1α concentration immediately after PCI and cardiac function index 1 year after PCI.Results The serum SDF-1α concentration in both groups was significantly increased after PCI, and RIC group was higher than control group, the differences were statistically significant(all P<0.05). RIC group CTFC was lower than the control(P=0.005). The LVEF of RIC group at 3 days after PCI was higher than that of control group(P=0.038). There were no significant differences in LVEDd, LVEDV, LVESV 3 days after surgery and LVEF, LVEDd, LVEDV, LVESV 1 year after PCI(all P >0.05). The serum SDF-1α concentration immediately after PCI was negatively correlated with LVEDd, LVEDV and LVESV 1 year after PCI(r=-0.338,-0.296,-0.314, all P<0.05). Conclusion Serum SDF-1α level significantly elevated in STEMI patients after PCI and RIC, and this increase is associated with improved ventricular remodeling.

关 键 词：基质细胞衍生因子1Α 急性ST段抬高心肌梗死 经皮冠状动脉介入治疗 远隔缺血适应 心室重构 

分 类 号：R542.22[医药卫生—心血管疾病]