急性心肌梗死后心肌微循环障碍与炎症反应的关系

The correlation between myocardial microcirculation and inflammation in acute myocardial infarction

目的通过心肌超声造影技术（MCE）观察急性心肌梗死（AMI）后心肌微循环障碍是否与炎症反应有关。方法入选患者81例（AMI组），发病24h内采集静脉血检测白细胞计数（WBC）、超敏C反应蛋白（hsCRP）、中性粒细胞百分比（G％）。根据WBC高低将AMI组分为A组（40例，WBC≥10×10^9／L）及B组（41例，WBC〈10×10^9／L）。30例健康者为对照组。入院5～7dAMI组及对照组进行MCE检查，检测各节段心肌造影剂强度（A）、心肌血流速率（β）、心肌血容量（MBF）。结果与正常组比较，A组WBC、hsCRP和B组hsCRP显著升高（P〈0．05）；A组MCE各指标显著低于B组（P〈0．05）；A组WBC、hsCRP与β值之间呈显著负相关（BWBC=-0．67，P〈0．05；BhsCRP=-0．51，P〈0.05）。结论AMI后炎症指标明显增高；炎症指标愈高，微循环灌注愈差。

Objective To investigate the correlation between myocardial microcirculation and inflammation in acute myocardial infarction（AMI） by myocardial contrast echocardiography（MCE）. Methods Eighty-one AMI patients （AMI group） and 30 healthy adults （normal control group） were enrolled. White blood cell （WBC）, hypersensitive C reactive protein （hsCRP） and neutrophilic granulocyte percentage （G%） were measured in patients and healthy adults. According to different count of WBC,AMI group was derided into A group （n = 40, WBC≥10 × l0^9/L） and B group （n= 41,WBC〈10 × 10^9/L）. Myocardial contrast intensity （A）,blood flow rate （β） and myocardial blood volume （MBF = A × β） of each segment were measured by MCE during 5-7 days of hospitalization. Results Compared with control group, WBC, hsCRP in A group and hsCRP in B group were significantly elevated （ P 〈0.05）. A,β and MBF in A group were significantly lower than those in B group （ P〈 0.05）. WBC and hsCRP in A group had significant negative correlations with 13 respectively （BWBC = - 0.67, P 0.05;BhsCRP = -0.51, P 〈0.05）. Conclusions The level of plasma inflammatory factors were remarkably increased after AMI,which had a positive correlation with low microclrculation perfusion.