冠心病患者血浆生长素水平与心功能和预后的相关性研究

Plasma ghrelin concentrations in patients with coronary artery disease correlates with heart function and prognosis

目的探讨冠心病患者血浆生长素水平与心功能和预后的关系。方法选择连续入院的冠心病患者83例为冠心病组,按疾病亚型又分为:急性ST段抬高心肌梗死(STEMI)31例,非ST段抬高急性冠状动脉综合征(NSTF-ACS)31例,稳定性心绞痛(SAP)21例。另选25例健康者为对照组。ELISA法检测患者入院1周内生长素水平,并与临床病史、血浆生化指标、心肌损伤标记物水平以及心功能指标进行相关性分析。结果冠心病组患者入院第1天生长素水平明显低于对照组。STEMI患者生长素水平随发病时间逐步升高,但至发病第7天仍未恢复至对照组水平。冠心病患者生长素水平与心肌损伤标记物峰值呈正相关,其中STEMI患者在发病1周内生长素水平与LVEF呈负相关。随访发现STEMI和NSTE-ACS惠者入院第3天,生长素在发生心功能不全和死亡患者中水平更高。结论冠心病患者低水平的生长素可能参与冠状动脉粥样硬化过程;急性心肌梗死后逐步升高的生长素反映了机体的代偿机制,并可能具有预后价值。

Objective To explore plasma ghreiin concentrations in patients with coronary artery disease and to analyze the relationships with heart function and prognosis. Methods Eighty-three patients with coronary artery disease that admitted in our center were recruited in the study, including 31 cases of STEMI,31 cases of NSTE-ACS and 9,1 cases of SAP. Twenty-five healthy subjects were recruited as controls. Plasma ghrelin concentrations of patients within 1 week after ad- mission were assayed with ELISA kit. Biochemical analysis, biomarkers of myocardial injury and indices of heart function were also measured. The subjects were followed up for new-onset cardiac events. Results Plasma ghrelin concentrations in patients with coronary artery disease were lower than those of healthy controls,though no significant difference was found between those of ACS and SAP. Plasma ghrelin levels of patients with STEMI elevated progressively after admission, but still lower than those of controls till day 7. Plasma ghrelin levels of patients with ACS correlated with peak value of biomarkers of myocardial injury. Ghrelin levels of patients with STEMI negatively correlated with LVEF. Patients that experienced new-onset cardiac dysfunction and died with follow up had significant higher levels of plasma ghrelin. Conclusion Low levels of plasma ghrelin may take part in the development of coronary atherosclerosis;the elevation of plasma ghrelin after acute coronary events reflected a compensatory mechanism,and suggested ghrelin as a cardiac protective factors has prognostic value.