摘要
目的探讨血清内脏脂肪素(VF)浓度变化与急性ST段抬高型心肌梗死(ASTEMI)的关系。方法选择2013年1—9月在昆明医科大学第一附属医院心内科住院的胸痛患者233例,其中ASTEMI患者78例(ASTEMI组),劳力性心绞痛(EA)患者112例(EA组),非冠心病患者43例(非冠心病组),均行PCI术。在患者行PCI术后12 h、24 h、3 d、1周、2周和1个月各采集血液标本1次,检测高敏C反应蛋白(hs-CRP)、肌红蛋白(MYO)、肌酸激酶同工酶(CK-MB)、肌钙蛋白-I(TnI)、白细胞计数(WBC)、脑钠素(BNP)和VF。另选取16只12周龄的C57/BL6小鼠,采用随机数字表法分为心肌梗死组和假手术组,各8只。心肌梗死组建立心肌梗死模型,假手术组除不结扎左冠状动脉外,给予其他同样手术处理。采用实时定量PCR检测两组小鼠左心室组织VF mRNA表达。结果3组患者性别、年龄、高血压史、糖尿病史、舒张压比较,差异均无统计学意义(P>0.05);3组患者收缩压、高脂血症史、BMI比较,差异均有统计学意义(P<0.05)。血液标本指标组间比较结果显示:3组hs-CRP、MYO、CK-MB、TnI、WBC、BNP、VF比较,差异均有统计学意义(P<0.05),其中PCI术后12 h、24 h、3 d,ASTEMI组VF均高于EA组和非冠心病组(P<0.05);组内比较结果显示:ASTEMI组、EA组和非冠心病组hs-CRP、MYO、CK-MB、TnI、WBC、BNP、VF在不同时间点比较,差异均有统计学意义(P<0.05),其中ASTEMI组术后24 h、3d的VF均高于术后12 h,术后1周、2周、1个月均低于术后12 h(P<0.05)。Pearson相关分析结果显示,ASTEMI组患者VF浓度(术后12 h)与CK-MB峰值(术后12 h)、TnI峰值(术后24 h)、WBC和BNP呈正相关(r=0.284、0.442、0.387、0.643,P<0.05)。心肌梗死组小鼠VF mRNA为(10.21±1.84),高于假手术组的(6.42±0.86)(t=3.44,P<0.05)。结论 ASTEMI患者血清VF浓度明显升高,并与WBC、心肌损伤标记物关系密切,可能对ASTEMI发病及病程判断有一定意义。
Objective To investigate the relationship between concentration of serum visfatin（ VF） and acute ST-segment elevation myocardial infarction（ ASTEMI）.Methods 233 patients hospitalized in our hospital from January to September,2013 were divided into three groups： ASTEMI group（ 78 cases）,effort angina group（ EA group）（ 112 cases） and non- coronary artery disease group（ 43 cases）.All of the patients received PCI.Blood samples were collected 12 h,24 h,3 d,1week,2 weeks and 1 month after PCI respectively to detect hs- CRP,MYO,CK- MB,TnI,WBC,BNP and VF.Meanwhile,according to random number table,16 C57 /BL6 mice of 12 week old were equally divided into MI group（ establishing myocardial infarction model） and sham operation group（ receiving the same operative treatment except ligation of left coronary artery） and the expression of VF mRNA in the left ventricular tissues was determined by real- time quantitative PCR.Results There was no significant difference of gender,age,hypertension,diabetes,diastolic blood pressure among the three patient groups（ P 0.05） and the difference of hyperlipidemia,BMI,systolic pressure was significant（ P 0.05）.Group comparison of blood sample indexes showed that the difference of hs- CRP,MYO,CK- MB,TnI,WBC,BNP and VF was not significant（ P 0.05）; VF of ASTEMI group was higher than that of other two groups 12 h,24 h,3 d after PCI.Intra- group comparison showed that the difference of hs- CRP,MYO,CK- MB,TnI,WBC,and VF of the three groups at different time points was significant（ P 0.05）; VF of ASTEMI group 24 h and 3 d after PCI was higher than that of 12 h after PCI and that of 1 week,2 weeks,1 month after PCI was lower than that of 12 h,with significant difference（ P 0.05）.Pearson correlation analysis showed that the concentration of VF（ 12 h after PCI） in ASTEMI group was positively correlated to peak value of CK- MB（ 12 h after PCI）,TnI（ 24 h after PCI）,WBC and BNP（ r = 0.284,0.442,0.387,0.643,P 0.05）.Further,in MI mice,mRNA level of VF was found to be（ 10.21 ± 1.84）,higher than that in sham- treated mice（ 6.42 ±0.86）（ t = 3.44,P 0.05）.Conclusion This study indicates that plasma VF levels are significantly higher in STEMI patients and that these higher VF levels are correlated with WBC and markers of myocardial injury,which may be significant in diagnosing and judging the course of disease of ASTEMI.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第28期3341-3345,共5页
Chinese General Practice
关键词
内脏脂肪素
急性ST段抬高型心肌梗死
白细胞
Visfatin
Acute ST-segment elevation myocardial infarction
White blood cell
