中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
13期
2385-2388
,共4页
尚茹茹%张锦%李爱萍%刘晓红
尚茹茹%張錦%李愛萍%劉曉紅
상여여%장금%리애평%류효홍
心肌梗死%可溶性ST2%心脏磁共振%心肌活性
心肌梗死%可溶性ST2%心髒磁共振%心肌活性
심기경사%가용성ST2%심장자공진%심기활성
Myocardial infarction%Serum ST2%Cardiac magnetic resonance imaging%Myocardial viability
目的：探讨急性心肌梗死患者早期血清可溶性ST2（sST2）水平及其与心肌活性的关系。方法采用ELISA法检测30例发病12 h以内的非ST段抬高型心肌梗死（NSTEMI）患者血清sST2水平，于发病后第7天行心脏磁共振检查并根据磁共振结果将患者分为透壁增强组、非透壁增强组和混合组。于7～14 d行PCI术，并于术后6个月再次行心脏磁共振检查评估心肌活性，观察指标包括梗死心肌质量、左心室射血分数及室壁运动异常评分在术前及术后的变化及其与心肌梗死早期血清sST2水平的关系。结果透壁增强组血清sST2的水平较之非透壁增强组及混合组明显升高（P＜0.05），混合组较非透壁增强组高（P＜0.05）；梗死心肌质量及室壁运动异常评分在3组患者PCI术后均减少，梗死心肌质量在非透壁增强组及混合组中减少有统计学差异（P＜0.05），室壁运动异常评分在非透壁增强组降低显著（P＜0.05）；左心室射血分数在3组患者PCI术后均增加，在非透壁增强组及混合组中增加有统计学差异（P＜0.05）。心肌梗死早期血清sST2水平与PCI术前及PCI术后6个月的心肌活性相关。结论急性心肌梗死早期血清中sST2的水平可反映心肌受损情况并可预测心肌梗死7 d PCI术前及PCI术后6个月的心肌活性。
目的：探討急性心肌梗死患者早期血清可溶性ST2（sST2）水平及其與心肌活性的關繫。方法採用ELISA法檢測30例髮病12 h以內的非ST段抬高型心肌梗死（NSTEMI）患者血清sST2水平，于髮病後第7天行心髒磁共振檢查併根據磁共振結果將患者分為透壁增彊組、非透壁增彊組和混閤組。于7～14 d行PCI術，併于術後6箇月再次行心髒磁共振檢查評估心肌活性，觀察指標包括梗死心肌質量、左心室射血分數及室壁運動異常評分在術前及術後的變化及其與心肌梗死早期血清sST2水平的關繫。結果透壁增彊組血清sST2的水平較之非透壁增彊組及混閤組明顯升高（P＜0.05），混閤組較非透壁增彊組高（P＜0.05）；梗死心肌質量及室壁運動異常評分在3組患者PCI術後均減少，梗死心肌質量在非透壁增彊組及混閤組中減少有統計學差異（P＜0.05），室壁運動異常評分在非透壁增彊組降低顯著（P＜0.05）；左心室射血分數在3組患者PCI術後均增加，在非透壁增彊組及混閤組中增加有統計學差異（P＜0.05）。心肌梗死早期血清sST2水平與PCI術前及PCI術後6箇月的心肌活性相關。結論急性心肌梗死早期血清中sST2的水平可反映心肌受損情況併可預測心肌梗死7 d PCI術前及PCI術後6箇月的心肌活性。
목적：탐토급성심기경사환자조기혈청가용성ST2（sST2）수평급기여심기활성적관계。방법채용ELISA법검측30례발병12 h이내적비ST단태고형심기경사（NSTEMI）환자혈청sST2수평，우발병후제7천행심장자공진검사병근거자공진결과장환자분위투벽증강조、비투벽증강조화혼합조。우7～14 d행PCI술，병우술후6개월재차행심장자공진검사평고심기활성，관찰지표포괄경사심기질량、좌심실사혈분수급실벽운동이상평분재술전급술후적변화급기여심기경사조기혈청sST2수평적관계。결과투벽증강조혈청sST2적수평교지비투벽증강조급혼합조명현승고（P＜0.05），혼합조교비투벽증강조고（P＜0.05）；경사심기질량급실벽운동이상평분재3조환자PCI술후균감소，경사심기질량재비투벽증강조급혼합조중감소유통계학차이（P＜0.05），실벽운동이상평분재비투벽증강조강저현저（P＜0.05）；좌심실사혈분수재3조환자PCI술후균증가，재비투벽증강조급혼합조중증가유통계학차이（P＜0.05）。심기경사조기혈청sST2수평여PCI술전급PCI술후6개월적심기활성상관。결론급성심기경사조기혈청중sST2적수평가반영심기수손정황병가예측심기경사7 d PCI술전급PCI술후6개월적심기활성。
ObjectiveTo investigate the levels of serum soluble ST2 in patients with early myocardial infarction and its relationship with myocardial viability.MethodsThe levels of serum soluble ST2 was measured with ELISA assay within 12 hours of the onset of NSTEMI in 30 patients, and 30 patients were subjected to cardiac magnetic resonance imaging on the 7th day of myocardial infarction and were divided into the following three groups by the transmural extent of myocardial infarction manifested in the delayed enhancement magnetic resonance imaging(DE-MRI):transmural enhancement group, non-transmural enhancement group and mixed group. All patients underwent PCI at 7-14 days after AMI and cardiac magnetic resonance imaging 6 months after the procedure to analyse the infarct mass, abnormal wall motion score and left ventricular ejection fraction(LVEF) and their relationship with the levels of serum ST2 in early stage of myocardial infarction.ResultsThe levels of serum ST2 in transmural enhancement group was significantly higher than that of non-transmural group and mixed group (P<0.05), mixed groupvs. non-transmural (P<0.05); Compared with the parameters before PCI, the infarct mass and abnormal wall motion score in three groups after PCI were decreased, but the infarct mass after PCI was significantly decreased in the non-transmural enhancement group and mixed group(P<0.05). Abnormal wall motion score was significantly decreased in the non-transmural enhancement group after PCI(P<0.05). LVEF was significantly improved after PCI in three groups, but the improvement in non-transmural enhancement group and mixed group were more significant(P<0.05). The levels of serum soluble ST2 in patients with early myocardial infarction were related with myocardial viability before PCI and 6 months after the procedure.ConclusionThe levels of serum soluble ST2 might imply myocardial injury in early myocardial infarction, and could be used to predict myocardial viability on the 7th day of myocardial infarction before PCI and 6 months after the procedure.
