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急性ST段抬高型心肌梗死患者中血清血管生成素的变化与心肌再灌注程度的研究

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目的 探究接受直接经皮冠状动脉介入治疗(P P C I)的S T段抬高型急性心肌梗死
(STEMI)患者血清血管生成素的变化以及与心肌再灌注程度的关系。方法 连续入选山西医科大学第
一医院于2017年12月至2018年12月行PPCI的STEMI患者100例及冠状动脉(冠脉)造影结果为阴性的
20例患者,根据心电图的单导联最大偏移幅度(MAXSTE)及心肌梗死溶栓治疗(TIMI)血流分级分
为再灌注程度良好组(60例)、再灌注程度较好组(24例)、再灌注程度不良组(16例),分析手术
前后血清血管生成素1(Ang1)、血管生成素2(Ang2)的变化和不同心肌再灌注程度之间的关系。结
果 PPCI前心肌再灌注程度良好组Ang1高于心肌再灌注程度不良组[23.88(15.06,24.09)ng/ml vs. 19.11
(16.69,21.74)ng/ml,P<0.05],术前、术后心肌再灌注程度良好组Ang2均低于心肌灌注程度不良组
[2.33(1.92,2.71)ng/ml vs. 3.11(2.89,3.55)ng/ml,P<0.05;1.68(1.34,1.85)ng/ml vs. 2.55(2.03,
2.70)ng/ml,P<0.05]。结论 对于行PPCI的STEMI患者,术前Ang1升高、Ang2降低和术后Ang2降低可作
为评估心肌再灌注程度的指标,有一定的预测价值。

Abstract:

Objective To study the relationship between changes of serum angiogenin (Ang) and status of
myocardial reperfusion in patients with acute ST-segment elevation myocardial infarction (STEMI) undergone
primary percutaneous coronary intervention (PPCI). Methods STEMI patients undergone PPCI (n=100) and
patients with negative results of coronary angiography (CAG, n=20) were chosen continuously from the First
Affiliated Hospital of Shanxi Medical University from Dec. 2017 to Dec. 2018. The patients were divided, according
to ECG max-ST-segment deviation (MAXSTE) and TIMI flow classification, into good reperfusion group (n=60),
better reperfusion group (n=24) and poor reperfusion group (n=16). The relationship between changes of serum
Ang1 and Ang2 and severities of myocardial reperfusion was analyzed before and after PPCI. Results Before
PPCI, the level of Ang1 was higher in good reperfusion group than that in good reperfusion group [23.88 (15.06,
24.09) ng/ml vs. 19.11 (16.69, 21.74) ng/ml, P<0.05]. Before and after PPCI, the level of Ang2 were all lower in
good reperfusion group than that in good reperfusion group [2.33 (1.92, 2.71) ng/ml vs. 3.11 (2.89, 3.55) ng/ml,
P<0.05; 1.68 (1.34, 1.85) ng/ml vs. 2.55 (2.03, 2.70) ng/ml, P<0.05]. Conclusion To STEMI patients undergone
PPCI, preoperative increase of Ang1 and decrease of Ang2 and postoperative decrease of Ang2 can be taken as an
indicator for reviewing the severity of myocardial reperfusion with some predictive value.

基金项目:

北京力生心血管健康基金会领航基金(LHJJ2014903)

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