急性心肌梗死溶栓治疗前后YKL-40的变化及意义

Changes and significance of YKL-40 after thrombolytic therapy for acute myocardial infarction

目的:探讨血清甲壳质酶蛋白40(YKL-40)在非ST段抬高心肌梗死和ST段抬高心肌梗死溶栓再通前后的变化及意义。方法:测定17例ST段抬高心肌梗死患者溶栓前及再通后YKL-40的水平,18例非ST段抬高心肌梗死患者YKL-40水平及20例健康状况良好、未发现心脏相关疾病健康体检者血清中的YKL-40,分别比较ST段抬高心肌梗死溶栓前与非ST段抬高心肌梗死及健康体检者的差异以及ST段抬高心肌梗死溶栓再通前后的差异。结果:ST段抬高心肌梗死患者溶栓前血清YKL-40水平[(157.56±52.35)μg/L(75.02～558.04μg/L)],显著高于健康体检组[(97.3±36.04)μg/L(53.2～199.05μg/L)](P<0.05)和非ST段抬高心肌梗死组[(124.3±41.12)μg/L(67.5～224.8μg/L)](P<0.05);健康体检者组与非ST段抬高心肌梗死组比较,差异有统计学意义(P<0.05)。溶栓再通后YKL-40水平为[(106.45±39.22)μg/L(64.13～159.24μg/L)],与溶栓前比较,差异有统计学意义(P<0.05)。溶栓再通后与健康体检者组比较,差异无统计学意义(P>0.05)。结论:血清YKL-40水平检测在急性心肌梗死的早期诊断、治疗效果方面有较大的临床价值。

Objective： To investigate the changes and its significance caused by serum enzyme chitin 40（YKL-40） after thrombolytic therapy for non-ST-segment elevation myocardial infarction and ST-segment elevation myocardial infarction.Methods： The serum YKL-40 levels of 17 patients with ST-segment elevation myocardial infarction before and after thrombolytic treatment,18 patients with non-ST-segment elevation myocardial infarction and 20 healthy people without any detected heart related diseases were detected.The patients with ST-segment elevation myocardial infarction before thrombolytic treatment was compared to patients with non-ST-segment elevation myocardial infarction,healthy people and patients with ST-segment elevation myocardial infarction after thrombolytic treatment.Results： The serum YKL-40 level of patients with ST-segment elevation myocardial infarction before thrombolytic treatment was [（157.56±52.35） μg/L（75.02-558.04 μg/L）],which was significantly higher than [（97.3±36.04） μg/L（53.2-199.05 μg/L）] of healthy people（P0.05） and [（124.30±41.12） μg/L（67.5-224.8 μg/L）] of patients with non-ST-segment elevation myocardial infarction（P0.05）.The YKL-40 levels between healthy people and patients with non-ST-segment elevation myocardial infarction were statistically significant（P0.05）.The YKL-40 level after thrombolytic therapy was [（106.45±39.22） μg/L（64.13-159.24 μg/L）,which was significantly different from that before thrombolytic therapy（P0.05）,but was no significantly different compared with the health group（P0.05）.Conclusion： Early diagnosis of serum YKL-40 levels in the patients with acute myocardial infarction has important clinical value in therapeutic effects.