肝细胞生长因子对急性心肌梗死后左室重构的预测作用

Serum hepatocyte growth factor in predicting left ventricular remodeling after acute myocardial infarction

目的:探讨血清肝细胞生成因子(HGF)对急性心肌梗死(AMI)后早期左室重构的预测价值。方法:36例AMI患者入院时及发病7 d测定血清HGF水平;AMI其中的26例分别于发病后7～10 d及发病后3个月行超声心动图检查,3个月时左室舒张末期容积指数(LVEDVI)与7～10 d时比增加≥5 ml/m2定义为左室重构组(n=11),对两组血清HGF值进行比较。结果:AMI患者入院时血清HGF浓度较对照组明显升高[(809±288)ng/Lvs.(620±162)ng/L,P<0.01],7 d时升高更显著[(1 607±1 355)ng/L,P<0.01]。发病7 d时血清HGF浓度在左室重构组较非左室重构组升高[(2 216±1 522)ng/Lvs.(1 176±593)ng/L,P<0.05],而入院时两组浓度则无显著差异。结论:AMI时血清HGF浓度升高,AMI后7 d时增高的血清HGF可能预示心室重构。

AIM： To investigate the clinical significance of serum hepatocyte growth factor （HGF） in predicting left ventricular remodeling after acute myocardial infarction （AMI）. METHODS： Venous blood samples were obtained at hospital admission and 7 days after in 36 patients with AMI and in 27 control subjects. Left ventrieular end-diastolic volume index （LVEDVI） in the subacute （7 - 10 days） and chronic （3 months） phases was assessed in 26 patients with AMI. Left ventricular remodeling group （n = 11 ） was defined as an increase in LVEDVI 5 ml/m^2 in chronic phase relative to the subacute phase. RESULTS： Serum HGF concentrations were higher in newly admitted patients with AMI than those in controls [ （809 ±288） vs. （620 ± 162） ng/L, P 〈0. 01 ] and the difference was more significant on day 7 （1 607 ± 1 355 ng/L） than at admission （P 〈0.01）. HGF concentration on day 7 was higher in the remodeling group than in the nonremodeling group [ （2 216 ± 1 522） vs. （1 176 ± 593 ） ng/L, P 〈 0. 05 ], whereas no difference was observed between the groups at admission. CONCLUSION： Serum HGF concentration is elevated in patients with AMI. Elevated serum HGF concentrations on day 7 after AMI may forebode left ventricular remodeling.