摘要
目的探讨血清抗心肌肌钙蛋白I自身抗体(cTnIAAb)在急性心肌梗死患者中的表达水平及其与左心室重构的关系。方法选取2016年1月至2018年3月于北京安贞医院收治的143例急性心肌梗死患者为研究对象,根据美国纽约心脏病协会(NYHA)制定的心功能分级标准将其分为NYHAⅡ级(n=62)、NYHAⅢ级(n=47)、NYHAⅣ级(n=34),并于同期随机选取40例健康体检者为对照组(n=40),采用酶联免疫吸附法检测入院时各组血清cTnIAAbA450nm值,超声心动图检查各组左心室重构指标,包括左心室舒张末期直径(LVEDD)、左心室收缩末期直径(LVESD),M型超声检测左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF),并计算左室心肌质量指数(LVMI)。结果不同NYHA分级急性心肌梗死患者血清cTnIAAbA450nm值均高于对照组,且随着NYHA分级越高,血清cTnIAAbA450nm值呈升高趋势,差异均有统计学意义(P<0.05)。不同NYHA分级急性心肌梗死患者心室重构参数LVEDD、LVESD、LVEDV、LVESV、LVMI水平均大于对照组,LVEF水平低于对照组,且随着NYHA分级越高,患者心室重构参数LVEDD、LVESD、LVEDV、LVESV、LVMI越大,LVEF越小,差异均有统计学意义(P<0.05)。Pearson积矩相关分析显示,急性心肌梗死患者血清cTnIAAb与心室重构参数LVEDD、LVESD、LVEDV、LVESV、LVMI均呈正相关性(r=0.637、0.598、0.517、0.562、0.632,P<0.05),与LVEF呈负相关性(r=-0.622,P<0.05)。结论血清cTnIAAb升高与急性心肌梗死左心室重构密切相关,早期检测可作为评估患者病情严重程度的重要指标。
Objective To investigate the expression level of serum anti-cardiac troponin I autoantibody (cTnIAAb) in patients with acute myocardial infarction and its relationship with left ventricular remodeling. Methods A total of 143 patient with acute myocardial infarction admitted to Anzhen hospital from January 2016 to May 2018 as subjects,which were divided into NYHA class Ⅱ(n=62),NYHA class Ⅲ(n=47) and NYHA class Ⅳ(n=34) according to the cardiac function classification criteria formulated by the New York Heart Association (NYHA). 40 healthy volunteers were randomly selected as control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the A450 nm value of serum cTnIAAb in each group at admission,and left ventricular remodeling indexes such as LVEDD,LVESD were examined by echocardiography,and LVEDV,LVESV,LVEF, LVMI were measured by M-mode ultrasound. Results The A450 nm value of serum cTnIAAb in patients with acute myocardial infarction of different NYHA grades was higher than that of the control group,and the higher the NYHA grade,the higher the A450 nm value of serum cTnIAAb,the difference was statistically significant (P<0.05). The levels of LVEDD,LVESD,LVEDV,LVESV and LVMI in patients with acute myocardial infarction with different NYHA class were higher than those in control group,and which showed an increasing trend with the higher NYHA class,while LVEF level in patients with acute myocardial infarction with different NYHA class was lower than that in control group,and which showed an increasing trend with the higher NYHA class,the difference was statistically significant (P<0.05). Pearson product moment correlation analysis showed that serum cTnIAAb was positively associated with LVEDD,LVESD,LVEDV,LVESV and LVMI (r=0.637,0.598,0.517,0.562,0.632;P<0.05),which was negatively associated with LVEF (r=-0.622;P<0.05). Conclusion Abnormal elevation of serum cTnIAAb is closely related to left ventricular remodeling in patients with acute myocardial infarction. Early detection of cTnIAAb may be an
作者
马鸣飞
马衫杉
屠琛琛
张春晓
刘燕
王以新
马立萍
冯妍
Ma Mingfei;Ma Shanshan;Tu Chenchen;Zhang Chunxiao;Liu Yan;Wang Yixin;Ma Liping;Feng Yan(Department of General medical,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)
出处
《中国循证心血管医学杂志》
2019年第5期574-577,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
首都卫生发展科研专项项目(首发2014-3-2063)
关键词
抗心肌肌钙蛋白I自身抗体
急性心肌梗死
左心室重构
Cardiac troponin I autoantibody
Acute myocardial infarction
Left ventricular remodeling
