冠心病患者外周血单核细胞镁浓度对心室重塑的影响

Effects of Magnesium Concentration of Peripheral blood mononuclear cell on ventricular remodeling in patients with coronary artery disease

目的观察冠心病患者外周血单核细胞镁浓度、血清基质金属蛋白酶-9水平变化及其与心室重塑、心功能的关系。方法选择78例冠心病患者,根据左室射血分数(LVEF)分为3组,1组LVEF>0.50、2组LVEF>0.35、3组LVEF<0.35。测定患者外周血单核细胞内镁(Mg)及血清白细胞介素-6(IL-6)、基质金属蛋白酶-9(MMP-9)水平,超声测定左室收缩末期容量指数(LVESVI)、舒张末期容量指数(LVEDVI)。结果随着LVEF降低,患者血单核细胞Mg降低、血清IL-6及MMP-9显著增高(P<0.05);LVEDVI、LVESVI与Mg均呈负相关(相关系数分别是r=-0.49,r=-0.43;P<0.01),LVEDVI与IL-6、MMP-9呈正相关(相关系数分别是r=0.41,r=0.47;P<0.01);Mg与IL-6及MMP-9均呈负相关(相关系数分别是r=-0.47,r=-0.58;P<0.01)。结论冠心病患者的心肌重塑及收缩功能障碍,可能与细胞内缺镁有关。

Objective To observe the change in peripheral blood intramonocyte ionized magnesium concentration and serum matrix metalloproteinase-9 level and relations between these changes and ventricular remodeling in patients with coronary artery disease （CHD）. Methods 78 patients with CHD were randomly into three groups： Left ventricular ejection fraction （LVEF） 〉0.50 in group 1 ; LVEF 〉0.35 in group 2; LVEF 〈 0.35 in group 3. left ventricular end systolic volume index （LVESVI） and left ventricular end diastolic volume index （LVEDVI） were measured by Echo-Doppler, intramonocyte ionized magnesium, serum interleukin -6 and matrix metalloproteinases-9 （MMP-9） level were assayed also. Results With the decreased LVEF, the intramonocyte magnesium decreased, serum interleukin-6 and MMP-9 levels were increased significantly（ P 〈 0.05 ）, LVEDVI, LVESVI were negative correlation with the intramonocyte magnesium（ LVEDVI ： r = - 0.49 ; LVESVI ： r = - 0. 43 ; P 〈 0.01 ）, while LVEDVI was positive correlation with interleukin-6 and MMP-9, respectively （ r = 0. 41,0. 47 ,P 〈0.01 ） ; intramonocyte magnesium was negative correlation with interleukin-6 and MMP-9, respectively （ r = - 0. 47, - 0. 58, P 〈 0.01 ）. Conclusion Cardiac remodeling and contractile dysfunction is involved decrease in intramonocyte magnesium in patients with CHD.