摘要
目的评价急诊和择期经皮冠状动脉介入治疗(PCI)对急性心肌梗死(AMI)患者心脏胶原重塑的影响。方法对40例AMI患者在内科保守治疗的基础上分别予急诊PCI(急诊组,n=21例)和择期PCI(择期组,n=19例)治疗,应用酶联免疫法检测AMI患者发病1周、3个月、6个月及12个月时的血清Ⅰ型前胶原羧基端肽(PⅠCP)和Ⅲ型前胶原(PCⅢ)水平;以47例健康体检者为正常对照组。结果与对照组比较,急诊组与择期组1周PⅠCP及PCⅢ水平均显著升高,PⅠCP/PCⅢ比值均显著降低(P<0.05);急诊组及择期组内6个月PⅠCP水平均较3个月显著升高,12个月较6个月显著降低,而12个月PCⅢ水平较3个月显著降低(P<0.05);急诊组与择期组6个月PⅠCP/PCⅢ比值较3个月显著升高(P<0.05),而至12个月时呈两组均呈下降趋势;急诊组6个月PⅠCP水平、3个月PCⅢ水平均较择期组同期水平显著降低(P<0.05)。结论从抑制胶原合成代谢亢进而言,急诊PCI在AMI后6个月内明显优于择期PCI治疗,而至12个月时急诊PCI未进一步显示出此方面的优越性。
Objective To evaluate influence of emergency and selective percutaneous coronary intervention（PCI） on cardiac collagen remodeling in patients with acute myocardial infarction（AMI）. Methods According to the different therapies, forty patients with AMI were divided into two groups： emergency PCI （emergency group, n = 21） and selective PCI （selective group, n = 19）. The serum concentration of carboxy-terminal propeptide of procollagen type Ⅰ （P Ⅰ CP） and precollagen Ⅲ type（PCⅢ） of the patients with AMI were measured by euzyme linked immunosorbent assay on the 1st week,the 3rd month,the 6th month and the 12th month after AMI. And 47 healthy people from body-check served as control group. Results Compared with that of control group, the serum concentration of P I CP and PCⅢ in the patients were increased on the 1st week, and the ratio of P I CP/PC Ⅲ was decreased after AMI in emergency group and selective group（ P〈0.05）. In emergency group and selective group, the level of P I CP was higher on the 6th month than that on the 3rd month,and was lower on the 12th month than that on the 6th month, while serum concentration of PCⅢ was higher on the 3rd month than that on the 12th month（ P〈0.05）. The ratio of P I CP / PCⅢ was increased on the 6th month than that on the 3rd month（ P〈0.05） ,and lower on the 12th month than on the 6th month. Serum concentrations of P I CP on the 6th month and serum concentration of PCⅢ on the 3rd month were lower in emergency group than those in selective group （ P〈0.05）. Conclusion For inhibiting cardiac collagen synthesis and metabolism after AMI, emergency PCI is better than selective PCI in the 6th month, while no significant differences are observed between emergency and selective PCI on the 12th month.
出处
《临床荟萃》
CAS
北大核心
2008年第14期999-1002,共4页
Clinical Focus
基金
贵州省科学技术基金资助项目[黔基合计字(2003)3043]
贵州省高层次人才科研条件特助经费项目[黔人领函(2005)14]
关键词
心肌梗死
血管成形术
经腔
经皮冠状动脉
心室重塑
myocardial infarction
angioplasty
transluminal
percutaneous coronary
ventricular remodeling
