摘要
目的观察急性心肌梗死（AMI）患者梗死相关血管（IRA）开通前后脂联素的动态变化及其与心肌组织水平灌注状态的关系。方法①测定20例冠脉造影正常健康人和60例AMI患者急诊冠状动脉介入治疗（PCI）前即刻、术后12小时、24小时血浆脂联素及白细胞介素6（IL-6）的变化。②按照再灌注后2小时心电图ST段回落是否〉70％，将60例AMI患者分为A组（ST段回落≥70％）34例和B组（ST段回落≥70％）26例，比较两组患者血浆脂联素及IL-6的变化幅度。③另根据心肌灌注分级（TMPG）将患者分为两组：TMPG2～3组36例，TMPGO～1组24例，比较两组患者血浆脂联素及IL-6的变化幅度。结果①A、B两组患者血浆脂联素水平在再灌注后12小时（3．56±1．52）mg／Lvs（2．88±1．67）mg／L、24小时（3．34±1．36）mg／Lvs（2．65±1．14）mg／L较术前（4．21±2．63）mg／Lvs（4．18±1．62）mg／L显著降低（P〈0．05，P〈0．01）；两组血浆IL．6水平较术前明显升高（均P〈0．01）。A、B两组间比较，成功PCI、IRA血流达TIMI3级者，B组患者血浆脂联素水平，在再灌注12小时、24小时均显著低于A组[（2．881±1．67）mg／Lvs（3．56±1．52）mg／L，（2．65±1.14）mg／Lvs（3．34±1．36）mg／L，均P〈0．053；B组患者血浆IL-6水平，在再灌注12小时显著高于A组（P〈0．01），在再灌注24小时仍然高于A组（P〈0．05）。②TMPG2～3、TMPG0～1两组血浆脂联素水平在再灌注后12小时（3．49±1．61）mg／Lvs（2．76±1．27）mg／L、24小时（3．33±1．35）mg／Lvs（2．63±1．22）mg／L较术前（4．23±2．16）mg／Lvs（4．19±1．78）mg／L显著降低（P〈0．05，P〈0．01）；两组血浆IL-6水平较术前明显升高（P〈0．01）。TMPG2～3与TMPG0／1两组间比较，成功PCI后，TMPGO～1组患者血浆脂联素水平，在再灌注12小时、24小时均显著低于TMPG2～3组（均P〈0．05�
Objective To observe the dynamic change of adiponectin before and after the reopening of infarction related artery（IRA） in acute myocardial infarction（AMI） patients and its relationship with reperfusion state in the myocardial tissue level. Methods ① The plasma level of adiponectin and interleukin-6 （IL-6） were determined in 20 healthy persons with normal coronary angiograms and in 60 AMI patients before percutaneous coronary intervention （PCI） ,and 12,24 hours after PCI. ② All the AMI patients were classified into two groups according to ST segment changes 2 hours after reperfusion. A group： ST segment resolutionS70% （34 cases）. 13 group：ST segment resolution〈70%（26 cases）. The comparison of adiponectin and IL-6 change was done between two groups. ③ According to TIMI Myocardial Perfusion Grade（TMPG）, the patients were again assigned into two groups-TMPG 2/3 group（36 cases） and TMPG0/1 group（24 cases）. The comparison of adiponectin and IL-6 change was also done between two groups. Results ① The plasma level of adiponectin was significantly lower 12 and 24 hours after reperfusion than before the operation in both A and B group （3.56±1.52） mg/L vs （4.21±2.63） mg/L, （2.88±1.67） mg/L vs （4.18±1.62） mg/L（all P 〈0.05）, （3.34± 1.36） mg/L vs （4.21±2.63） mg/L, （2.65 ± 1.14） mg/L vs （4.21 =[= 2.63） mg/L（all P 〈0.01）. The plasma level of IL-6 was higher after than before the operation（ P 〈0.01）. The plasma level of adiponectin was significantly lower in B group than in A group （2.88 ± 1.67） mg/L vs （3.56±1.52） mg/L, （2.65 ±1.14 ） vs （ 3.34 ± 1.36 ） mg / L （ all P 〈 0.05 ） at 1 2 and 2 4 hours after reperfusion. The plasma level of IL - 6 was significantly higher in B group than in A group 12 and 24 hours after reperfusion （ P〈0.01, P〈0.05）. OThe plasma level of adiponectin was significantly lower in both TMPG2/3 and TMPG0/1 group at 12,24 hours after reperfusion than before the operat
出处
《临床荟萃》
CAS
北大核心
2007年第14期994-997,共4页
Clinical Focus
基金
河北省科技厅重大项目(06276107D)
河北省教委博士基金(B2004126)
河北省卫生厅重点跟踪项目(0413)
关键词
心肌梗塞
再灌注损伤
血管成形术
经腔
经皮冠状动脉
myocardial infaction
reperfusion injury
angioplasty
transluminal
percutaneous coronaryangiography
