摘要
目的探讨人半乳糖凝集素-3(Gal3)在急性心肌梗死(AMI)行急诊经皮冠状动脉介入治疗术(PCI)的患者中的表达变化及Gal3水平与心肌梗死范围、冠脉内血栓负荷、心室重塑的关系。方法选择2018年1月-8月于贵州省人民医院心内科诊断AMI并行急诊PCI的患者62例,患者于入院即刻、PCI术后3及5天分别抽血测Gal3,PCI术后24 h检测肌钙蛋白I(CTNI)。术后24h完善心脏彩超。按冠脉造影结果分为单支病变组,双支病变组及三支病变或左主干病变3组,计算Gensini积分。依据冠脉造影时影像将冠脉内血栓负荷分为0~5级。从中分析入院即刻、PCI术后3及5天Gal3水平的变化及其分别与肌钙蛋白、冠脉病变及血栓负荷等的关系。结果患者入院、术后第3天及术后第5天的Gal3分别为(93.38±9.37)ng/L、(82.76±7.43)ng/L及(72.71±7.58)ng/L,其水平逐步降低,三组间比较差异有统计学意义(F=99.17,P<0.001)。单支病变组、双支病变组及三支病变或左主干病变组患者Gal3入院、Gal3术后第3天及Gal3术后第5天水平的差异均无统计学意义(P>0.05)。Gal3入院、Gal3术后第3天及Gal3术后第5天水平皆与Gensini积分无显著相关性(P>0.05)。依据冠脉血栓分级将患者分为血栓分级0级组(T0组)及血栓分级1-5级组(T1-5组),T1-5组入院时Gal3水平明显高于T0组,为(95.6±7.31)ng/L对(89.62±11.3)ng/L,两组差异有统计学意义(P=0.014);术后第3天及第5天T1-5组Gal-3水平也明显高于T0组,差异有统计学意义(P=0.014,P=0.006)。Pearson相关分析显示:入院、术后第3天及术后第5天的Gal-3水平都与患者的PCI术后24 h的肌钙蛋白I水平呈正相关;与左室射血分数(LVEF)呈负相关。结论 Gal-3在AMI急性期释放,行急诊PCI术后5天内逐步下降。Gal-3水平与AMI患者冠脉血栓负荷有关,血栓负荷越重,Gal-3水平越高。Gal-3水平与AMI患者心肌坏死范围呈正相关,与急诊血运重建术后患者LVEF呈负相关,反映Gal-3�
Objective To investigate the expression changes of human galectin 3(Gal-3)in patients with acute myocardial infarction undergoing emergency PCI and to assess the relationship between Gal-3 level and myocardial infarction range,coronary thrombotic load and ventricular remodeling.Methods Totally 62 patients with AMI who underwent emergency PCI in the department of cardiology of our hospital from January to August of 2018 were selected. Blood samples were taken for Gal-3 determination immediately after admission, 3 and 5 days after PCI. Troponin I was measured in 24 hours after PCI.Echocardiography was completed 24 hours after PCI. The patients were divided into three groups according to the results of coronary angiography: the single-vessel disease group, the two-vessel disease group and the three-vessel disease or the left main disease group.Gensini cumulative index was calculated. According to the imaging of coronary angiography, the coronary thrombus load was divided into 0-5 grades. The changes of Gal-3 level on admission to hospital,and at 3 and 5 days after PCI were analyzed and their relationship with troponin, coronary artery diseaseand thrombus load was analyzed.Results 1. Gal-3 levels were gradually reduced on admission, at 3 days after PCI and 5 days after PCI,which were respectively(93.38 ± 9.37)ng/L,(82.76 ± 7.43)ng/L and(72.71 ± 7.58)ng/L, and there were statistically significant differences among the three groups(F=99.17,P<0.001). 2. There was no difference among singlevessel disease group, and the two-vessel disease group,the three-vessel disease group in Gal-3 levels on admission, 3 days after PCI and 5 days after PCI(P>0.05). No correlation was found between Gal-3 levels and Gensini cumulative index(P>0.05). 3. The patients were divided into the group with thrombus level 0(T0 group)and the group with thrombus level 1-5(T1-5 group). Compared to the T0 group,the admission level of Gal-3 was significantly higher in the T1-5 group,which was(95.6±7.31)g/L vs.(89.62±11.3)ng/L,and the difference bet
作者
杜发旺
陈丹丹
吴玥婷
王纪人
陈保林
DU Fa-wang;CHEN Dan-dan;WU Yue-ting;WANG Ji-ren;CHENG Bao-lin(Department of Cardiology,Guizhou Provincial People's Hospital,Guiyang 550002)
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2019年第11期985-990,共6页
Chinese Journal of Practical Internal Medicine
基金
国家临床重点专科建设项目[国卫办医函(2013)554号]
贵州省科学技术厅临床研究中心项目[黔科合平台人才(2017)5405]
贵州省科技厅基金[黔科合基础(2017)1103]
贵州省卫计委科学技术基(gzwjkj2018-1-005)
