摘要
目的 观察急性心肌梗死 (acutemyocardialinfarction ,AMI)患者早期血清Ⅲ型前胶原 (procollagenⅢ ,PCⅢ )含量的变化及其对抗心肌纤维化的反应 ,探讨血清PCⅢ检测对AMI心肌纤维化的评估价值。方法 采用放免法检测 4 3例AMI患者血清PCⅢ、血管紧张素Ⅱ (angiotensinⅡ ,AngⅡ )水平 ,酶免疫测定法检测肌酸磷酸激酶同工酶MB(CK MB)水平。并将患者随机分成两组 :常规治疗组 2 2例和苯那普利组 2 1例。后者在常规治疗的基础上加用血管紧张素转换酶抑制剂苯那普利渐增量进行干预治疗。所有患者分别在治疗前 ,治疗后 1、3、7和 14天抽取肘静脉血 ,分离血清 ,检测上述指标。正常健康人同批抽血分离血清 ,进行检测。结果 AMI患者治疗前上述血清学指标与健康对照组比较均显著高于后者 (P <0 .0 1)。常规治疗组在常规治疗 7天后PCⅢ和AngⅡ浓度达到高峰 ,显著高于治疗前和治疗 14天的浓度 (P <0 .0 5 ) ;苯那普利组在治疗 7、14天后PCⅢ浓度显著低于治疗前 (P <0 .0 5 ) ,治疗 3、7和 14天后AngⅡ浓度显著低于治疗前 (P <0 .0 5 )。CK MB浓度在治疗后 1天达到高峰 ,显著高于其他各时间段 (P均 <0 .0 5 ) ;治疗后 3、7和 14天降至正常。AMI患者血清PCⅢ水平与CK MB水平无相关关系 (r =- 0 .2 0 14 ,P >0 .0
Objective To observe the changes of serum type Ⅲprocollagen(PCⅢ) in early acute myocardial infarction(AMI) and reaction of antimyocardial fibrosis, to evaluate serum PCⅢin myocardial fibrosis with AMI.Methods The concentrations of serum PCⅢand angiotensinⅡ(AngⅡ) were measured by radioimmunoassay in 43 patients with AMI, the serum concentrations of creatine kinase isoenzymes MB(CK MB) also were measured by enzym immounoassay at the same time. These patients were divided randomly into two subgroups: conventional group 22 cases, benazepsil interventional group 21 cases.The latter were treated by incremental dosage of benazepril on conventional therapy. Normal healthy subjects were sampled and tested at the same batch. Blood was sampled in all these patients on before, 1 d, 3 d, 7 d, 14 d of therapy.Results The concentrations of serum PCⅢ,AngⅡ,CK MB in AMI were significantly higher than normal control(P< 0.01 ).The concentrations of serum PCⅢ and AngⅡin conventional group reached the highest at 7 d and were significantly higher than before and 14 d of therapy(P< 0.05 ).The levels of serum PCⅢ in benazepril interventional group before therapy were lower significantly than 7 d,14 d after therapy, but concentrations of AngⅡat 3 d,7 d and 14 d after therapy were lower significantly than before therapy. The concentrations of CK MB at 1d were significantly higher than any other time stages (P< 0.05 ) and decreased normal at 3 d,7 d,14 d. The levels of serum PCⅢwere not related to CK MB(r= 0.2014 ,P> 0.05 ),however they were positively related to AngⅡ(r= 0.5034 ,P< 0.01 ).Conclusions Serum concentrations of PCⅢ is a useful marker of reflecting the degree of tissue synthesis of collagen with AMI and can be used to evaluate effect of antifibrosis therapy.
出处
《临床荟萃》
CAS
北大核心
2003年第5期243-245,共3页
Clinical Focus
关键词
心肌梗塞
心内膜心肌纤维化症
胶原
myocardial infarction
endomyocardia fibrosis
collagen
