血清C3、C4水平与急性心肌梗死心肌损伤的相关性

Association of complement factor 3 and 4 levels in serum with myocardial injury in acute myocardial infarction

目的探讨血清C3和C4水平与急性心肌梗死(AMI)心肌损伤的关系及其临床意义。方法采用胶乳增强免疫比浊法测定40例具有溶栓指征的AMI患者入院第1天血清高敏C反应蛋白(hs-CRP)、C3及C4水平,采用化学发光法测定其血清肌钙蛋白(cTnI)水平,并与同期40例健康体检者进行对比分析。经溶栓治疗后,检测AMI患者第3天的血清C3和C4水平,并与入院第1天进行对比分析。结果与对照组相比,AMI组血清C3和C4水平明显降低,差异有统计学意义(均P<0.001),而hs-CRP和cTnI水平均显著增加,差异有统计学意义(P=0.005和P<0.001)。AMI组血清C3水平与血清hs-CRP和cTnI呈正相关(P<0.001和P=0.005),而且C4水平与与血清hs-CRP和cTnI亦呈正相关,P均<0.001(r=0.552、0.535)。经治疗后,AMI患者入院第3天的血清C3和C4水平较治疗前明显增高,P均<0.001(u=5.418、5.407)。结论AMI患者的血清C3、C4水平增高与心肌损伤有关,可用于AMI的病情判断和预后评价。

Objective To investigate the relationship between complement factor 3 and 4 levels in serum and myocardial injury in acute myocardial infarction （AMI） and its clinical value. Methods Latex-enhanced immunoturbidity method was employed to measure the serum high-sensitivity C-reactive protein （hs-CRP）, complement factor 3 （C3） and 4 （C4） levels on admission in 40 AMI patients with indications for thrombolysis, and simultaneously chemiluminescence method was used to determine the cardic troponin I （cTnI） level, in comparison to 40 healthy subjects at the same stage. After thrombolysis therapy, serum C3 and C4 levels were detected on day 3 after admission compared with those on day 1. Results The serum C3 and C4 levels were markedly decreased in the AMI group than those in the control group, showing statistical differences among them （all P〈0. 001）, while the serum hs-CRP and cTnI levels were raised considerably with significant differences between two groups （P= 0. 005, 〈0. 001, respectively）. And the serum C3 level was positively related to serum hs-CRP and cTnI levels （r=0. 662, 0. 433 respectively）, and serum C4 was positively correlated with serum hs-CRP and cTnI levels, both P〈0. 001 （r=0. 552, 0. 535 respectively）. After thrombolysis therapy, the serum C3 and C4 levels in AMI patients were significantly higher on admission than those on day 3 after admission, both P〈0. 001 （u=5. 418, 5. 407 respectively）. Conclusion Increased serum C3 and C4 levels in AMI patients were associated with myocardial injury, aiding in judging disease condition and assessing its prognosis.