CAJ | 학술논문

目的：观察急性心肌梗死（AMI）后急性心力衰竭患者血清卵泡抑素样蛋白‐1（FSTL‐1）水平变化，探讨其临床意义。方法选择82例初发急性ST段抬高型心肌梗死（STEMI）并行急诊经皮冠状动脉介入治疗（PCI）术成功的患者，根据住院期间有无发生急性左心衰分为心力衰竭组（HF组）（35例）和非心力衰竭组（N H F组）（47例）；根据K illip分级将心力衰竭组分为3个亚组。选冠状动脉造影正常的40例患者为对照组。酶联免疫吸附法（ELISA）测定血清FSTL‐1，化学发光法测定血浆B型钠尿肽（BNP）。结果未发生心力衰竭时，HF组及NHF组FSTL‐1及BNP水平差异无统计学意义（P＞0.05），但均高于对照组（P＜0.05）。出现心力衰竭症状后，HF组中 FSTL‐1及BNP水平较 NHF组明显升高，差异有统计学意义（P＜0.05）。 HF组中， FSTL‐1及BNP水平均随着心功能分级升高而上升，差异有统计学意义（P＜0.05），且FSTL‐1水平与BNP水平呈明显正相关（r＝0.504，P＜0．05）。结论FSTL‐1与BNP水平在AMI患者中升高，随着心力衰竭的出现明显升高；FSTL‐1对AMI后急性心力衰竭的诊断及病情评估具有一定价值。
목적：관찰급성심기경사（AMI）후급성심력쇠갈환자혈청란포억소양단백‐1（FSTL‐1）수평변화，탐토기림상의의。방법선택82례초발급성ST단태고형심기경사（STEMI）병행급진경피관상동맥개입치료（PCI）술성공적환자，근거주원기간유무발생급성좌심쇠분위심력쇠갈조（HF조）（35례）화비심력쇠갈조（N H F조）（47례）；근거K illip분급장심력쇠갈조분위3개아조。선관상동맥조영정상적40례환자위대조조。매련면역흡부법（ELISA）측정혈청FSTL‐1，화학발광법측정혈장B형납뇨태（BNP）。결과미발생심력쇠갈시，HF조급NHF조FSTL‐1급BNP수평차이무통계학의의（P＞0.05），단균고우대조조（P＜0.05）。출현심력쇠갈증상후，HF조중 FSTL‐1급BNP수평교 NHF조명현승고，차이유통계학의의（P＜0.05）。 HF조중， FSTL‐1급BNP수평균수착심공능분급승고이상승，차이유통계학의의（P＜0.05），차FSTL‐1수평여BNP수평정명현정상관（r＝0.504，P＜0．05）。결론FSTL‐1여BNP수평재AMI환자중승고，수착심력쇠갈적출현명현승고；FSTL‐1대AMI후급성심력쇠갈적진단급병정평고구유일정개치。
Objective To investigate the change of levels and clinical value of serum follistatin‐like protein 1 (FSTL‐1) in patients of acute myocardial infarction complicated with acute heart failure.Methods Eighty‐two pa‐tients undergoing successful primary percutaneous coronary intervention (PCI) for their first ST‐segment elevation myocardial infarction (STEMI) were selected .According to the occurrence of acute left heart failure in‐hospital , the patients were divided into heart failure (HF) group ( n=35)and non‐heart failure (NHF) group ( n =47) . According to the Killip class ,heart failure group is divided into three subgroups .Forty controls with normal coro‐nary arteries were chosen as control group .Serum levels of FSTL‐1 were detected by ELISA ,and plasma BNP concentration was detected by chemiluminescence method.Results When no heart failure occurred ,FSTL‐1 and BNP levels in HF group and NHF group were of no statistical difference ( P>0 .05) ,but were higher than those in normal control group ( P <0 .05) .When acute heart failure happened ,FSTL‐1 and BNP levels in HF group were significantly higher than those in NHF group( P<0 .05);In HF group ,FSTL‐1 and BNP levels were ele‐vated with the increase of heart function classification ( P<0 .05) ,and FSTL‐1was significantly positively corre‐lated with BNP( r = 0 .504 ,P <0 .05).Conclusion FSTL‐1 and BNP level increased in patients with STEMI , and increased significantly with the emergence of heart failure;FSTL‐1 had certain value in diagnosis and assessing disease status of heart failure after acute myocardial infarction .