中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2015年
9期
939-942
,共4页
孙飞%刘长青%胡高频%姜东炬
孫飛%劉長青%鬍高頻%薑東炬
손비%류장청%호고빈%강동거
心肌梗死%心室重构%基质金属蛋白酶类
心肌梗死%心室重構%基質金屬蛋白酶類
심기경사%심실중구%기질금속단백매류
Myocardial infarction%Ventricle remodeling%Matrix metalloproteinases
目的 探讨经皮冠状动脉介入术(PCI)治疗时间对急性ST段抬高型前壁心肌梗死(ASTEAWMI)患者血浆中基质金属蛋白酶(MMPs)和左心室重构的影响及MMPs与左心室重构的相关性. 方法 ASTEAWMI患者根据入院后PCI时间分为早期PCI组(发病至PCI＜18 h)72例和延迟PCI组(发病至PCI为2～3周)52例.检测心肌梗死后不同时间点MMP-2和MMP-9的活性;对比入院时及随访1年后的心脏超声检查结果,分析左心室舒张末期容积(LVEDV),左心室收缩末容积(LVESV)和左心室射血分数(LVEF)的变化及MMPs与左心室重构的相关性. 结果 早期PCI组心肌梗死后2d时MMP-9活性低于延迟PCI组,分别为(46±26) μg/L比(66±40) μg/L,(P=0.000);早期PCI组的LVEDV、LVESV变化低于延迟PCI组,分别为(10.9±6.2)ml比(15.0±6.0)ml、(-1.1±5.7)ml比(2.9±4.6)ml(均P=0.000),而LVEF变化高于延迟PCI组(5.5±4.0)％比(3.8±3.4)％(P=0.015);入院时、随访1年MMP-9的活性与LVEDV和LVESV变化呈正相关(r值分别为0.32、0.36,均P=0.000),与LVEF变化呈负相关(r=-0.29,P=0.001).结论 入院时MMP-9活性与心肌梗死后左心室重构和左心室功能相关,早期PCI可降低血浆中MMP-9的活性,改善心肌梗死后左心室重构情况.
目的 探討經皮冠狀動脈介入術(PCI)治療時間對急性ST段抬高型前壁心肌梗死(ASTEAWMI)患者血漿中基質金屬蛋白酶(MMPs)和左心室重構的影響及MMPs與左心室重構的相關性. 方法 ASTEAWMI患者根據入院後PCI時間分為早期PCI組(髮病至PCI＜18 h)72例和延遲PCI組(髮病至PCI為2～3週)52例.檢測心肌梗死後不同時間點MMP-2和MMP-9的活性;對比入院時及隨訪1年後的心髒超聲檢查結果,分析左心室舒張末期容積(LVEDV),左心室收縮末容積(LVESV)和左心室射血分數(LVEF)的變化及MMPs與左心室重構的相關性. 結果 早期PCI組心肌梗死後2d時MMP-9活性低于延遲PCI組,分彆為(46±26) μg/L比(66±40) μg/L,(P=0.000);早期PCI組的LVEDV、LVESV變化低于延遲PCI組,分彆為(10.9±6.2)ml比(15.0±6.0)ml、(-1.1±5.7)ml比(2.9±4.6)ml(均P=0.000),而LVEF變化高于延遲PCI組(5.5±4.0)％比(3.8±3.4)％(P=0.015);入院時、隨訪1年MMP-9的活性與LVEDV和LVESV變化呈正相關(r值分彆為0.32、0.36,均P=0.000),與LVEF變化呈負相關(r=-0.29,P=0.001).結論 入院時MMP-9活性與心肌梗死後左心室重構和左心室功能相關,早期PCI可降低血漿中MMP-9的活性,改善心肌梗死後左心室重構情況.
목적 탐토경피관상동맥개입술(PCI)치료시간대급성ST단태고형전벽심기경사(ASTEAWMI)환자혈장중기질금속단백매(MMPs)화좌심실중구적영향급MMPs여좌심실중구적상관성. 방법 ASTEAWMI환자근거입원후PCI시간분위조기PCI조(발병지PCI＜18 h)72례화연지PCI조(발병지PCI위2～3주)52례.검측심기경사후불동시간점MMP-2화MMP-9적활성;대비입원시급수방1년후적심장초성검사결과,분석좌심실서장말기용적(LVEDV),좌심실수축말용적(LVESV)화좌심실사혈분수(LVEF)적변화급MMPs여좌심실중구적상관성. 결과 조기PCI조심기경사후2d시MMP-9활성저우연지PCI조,분별위(46±26) μg/L비(66±40) μg/L,(P=0.000);조기PCI조적LVEDV、LVESV변화저우연지PCI조,분별위(10.9±6.2)ml비(15.0±6.0)ml、(-1.1±5.7)ml비(2.9±4.6)ml(균P=0.000),이LVEF변화고우연지PCI조(5.5±4.0)％비(3.8±3.4)％(P=0.015);입원시、수방1년MMP-9적활성여LVEDV화LVESV변화정정상관(r치분별위0.32、0.36,균P=0.000),여LVEF변화정부상관(r=-0.29,P=0.001).결론 입원시MMP-9활성여심기경사후좌심실중구화좌심실공능상관,조기PCI가강저혈장중MMP-9적활성,개선심기경사후좌심실중구정황.
Objective To investigate the effect of time from myocardial infarction (MI) onset to percutaneous coronary intervention (PCI) on plasma matrix metalloproteinases (MMPs) level and left ventricle (LV) remodeling in patients with acute ST-segment elevation myocardial infarction of anterior wall,and the relationship between MMPs and left ventricular remodeling.Methods All patients with anterior wall STEMI undergoing PCI were divided into early PCI group (PCI within 18 h after MI onset) and delayed PCI group (PCI between 2 and 3 weeks after MI onset).Plasma MMP-2 and MMP-9 activities were assayed on admission,and at 2 days,1 week after admission.One-year follow-up was finished after PCI.Left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume (LVESV) and left ventricle ejection fraction (LVEF) were measured by echocardiography at baseline and one year later to elucidate the effects of time from onset to PCI on LV remodeling and the relationship between MMP-2,-9 levels and LV remodeling.Results The MMP -9 activity at 2 days after myocardial infarction was lower in early PCI group than in delayed PCI group [(46±26)μg/L vs.(66±40) μg/L,P=0.000].The changes in LVEDV and LVESV (△LVEDV and △LVESV) were lower and the change in LVEF (△LVEF) was higher in early PCI group than in delayed PCI group [(10.9±6.2) ml vs.(15.0±6.0)ml,(-1.1±5.7) ml vs.(2.9±4.6) ml,(5.5 ±4.0) ％ vs.(3.8±3.4) ％,P=0.000,0.000 and 0.015].MMP-9 had positive correlations with △LVEDV and △LVESV,and a negative correlation with △LVEF at admission and after 1-year follow-up (r=0.32,0.36 and-0.29,respectively,P=0.000,0.000 and 0.001).Conclusions MMP-9 activity at admission is correlated with LV remodeling and LV function.Early PCI can reduce MMP-9 activity and improve LV remodeling after myocardial infarction.
