急性心肌梗死患者血浆Ⅲ型前胶原氨基末端肽与左室重构的关系  

Relationship between plasma concentration of amino-terminal propetide of type Ⅲ procollagen and left ventricular remodeling after acute myocardial infarction

作　　者：董士民[1] 刘坤申[2] 张晓光[3] 

机构地区：[1]河北医科大学第三医院急诊科,石家庄050051 [2]河北医科大学第一医院心内科 [3]河北医科大学第三医院心内科

出　　处：《临床心血管病杂志》2004年第1期14-16,共3页Journal of Clinical Cardiology

摘　　要：目的 :观察急性心肌梗死 (AMI)患者胶原代谢与早期左室重构的相互关系。方法 :AMI患者 32例 ,分为重构组 (18例 )与非重构组 (14例 )。应用放射免疫法测定血浆Ⅲ型前胶原氨基末端肽 (PⅢNP)含量 ,用超声心动图测量左室结构及舒缩功能参数 ,做相关分析 ,并与正常对照组 (30例 )比较。结果 :AMI患者第 4周、第 12周血浆PⅢNP含量分别为 (9.2 3± 3.13) μg/L、(6 .33± 2 .4 1) μg/L ,与第 2天 [(5 .2 2± 1.19) μg/L]及正常对照者[(5 .2 1± 1.18) μg/L]比较明显升高 (均 P <0 .0 1)。重构组第 4周、第 12周血浆PⅢNP含量均明显高于同时间点非重构组含量 (均P <0 .0 1)。第 4周、第 12周血浆PⅢNP含量与左室收缩末期容积呈正相关 (r =0 .4 0 5 ,r=0 .5 13,均P <0 .0 1) ,与二尖瓣血流舒张早期流速 /心房收缩期流速 (r =- 0 .386 ;r =- 0 .35 7,均P <0 .0 1)、左室射血分数 (r =- 0 .4 2 6 ;r =- 0 .346 ,均P <0 .0 1)均呈负相关。结论 :AMI后早期左室重构过程与心肌胶原代谢增强有关 。Objective: To observe the relationship between plasma amino-terminal propetide of type Ⅲ procollagen and left ventricular remodeling in acute myocardial infarction (AMI) . Methods: The 32 patients with AMI were divided into left ventricular remodeling group (LVR, n=18) and no-left ventricular remodeling group( NLVR, n=14 ). The plasma amino-terminal propetide of type Ⅲ procollagen(PⅢNP) was measure by specific radioimmunoassay. Doppler ultrasound recordings were abtained to determine serveral parameters relating to the left ventricular anatomy and function. Results: In comparison with control group, the level of plasma PⅢNP was significantly increased [( 9.23± 3.13),( 6.33± 2.41) vs ( 5.21± 1.18)μg/L, P< 0.01 respectively]in patient with AMI,at 4th, 12 th week. In the LVR group at 4 th, 12 th week , the levels of plasma PⅢNP was significantly highter than that of NLVR group [( 12.73± 3.2) vs ( 6.53± 2.61)μg/L;( 6.49± 3.1 ) vs ( 5.49± 2.93)μg/L. P< 0.01 respectively]. At 4 th, 12 th week, plasma levels of PⅢNP was significantly correlated positively with left ventircular end-systolic volume index(r= 0.405; r= 0.513, P< 0.01 respectively)and negatively with the V E/V A(r= - 0.386 ; r=- 0.357, P< 0.01 respectively)and negatively with LVEF(r =- 0.426;r=- 0.346, P< 0.01 respectively).Conclusion:Plasma levels of PⅢNP in the subacute phase of AMI are related to left ventircular function.

关 键 词：急性心肌梗死 血浆 Ⅲ型前胶原 氨基末端肽 左室重构 胶原代谢 

分 类 号：R542.22[医药卫生—心血管疾病]