急性冠脉综合征与血清促红细胞生成素关系探讨

Search of erythropoietin level in the patients with acute coronary syndrome

目的探讨急性冠脉综合征（acut ecoronary syndrome，ACS）患者促红细胞生成素（erythropoietin，EPO）水平特点。方法2010—06～2011—06共收治ACS患者131例，包括59例肌钙蛋白I（troponinI，TnI）〈0．3ng／mL（A组）及72例TnI≥0．3ng／mL（B组），比较两组患者氨基末端B型脑钠肽前体（NT—proBNP）、EPO水平，行超声心动图检查，测量左心室直径（1eftventricular diastole diameter，LVDd）、左室射血分数（left ventrieular ejection fraction，LVEF）及E／A比值；A组57例、B组40例患者行冠状动脉造影检查，A组52例、B组32例患者行经皮冠脉介入（percutaneous coronary intervention，PCI）治疗，比较两组PCI前后EPO水平变化。结果A组患者的总病变个数和B2／C病变个数少于B组；A组EPO水平高于B组（P〈0．05）；A组NT—pmBNP水平低于B组（P〈0．05）；两组LVDd、LVEF及E／A值比较差异无统计学意义。B组PCI术后EPO水平升高（P〈0．05），两组EPO水平的变化比较差异有统计学意义（P〈0．01）。结论随着ACS的危险分层升高，EPO水平降低；PCI能明显升高高危ACS患者EPO水平。

Objective To study the erythropoietin （EPO） level in the patients who suffered from acute coronary syndrome （ACS）. Methods 131 consecutive patients with ACS were divided into two groups： group A, 59 patients whose troponin I （TnI） level was lower than 0.3 ng/mL and B group, 72 patients whose TnI was higher than 0.3 ng/mL. 57 patients in group A and 40 patients in group B were performed coronary angiography （CAG） ; 52 patients in group A and 32 patients in group B were performed percutaneous coronary intervention （PCI）. The EPO level （including before and after the PCI treatment） and aminoterminal B -type brain natriuretic peptide （NT- proBNP） level were compared between two groups, as well the left ventricular ejection fraction （LVEF）, left ventricular diastolic diameter （LVDd） and E/A ratio were measured by ultrasonic cardiogram. Results The EPO level before PCI was higher in group A than in group B （P 〈 0.05 ）, but the EPO level after PCI was much higher in group B than in group A （ P 〈 0.05 ） ; the NT - proBNP level was lower in group A than in group B （P 〈 0.05） ;there were no differences in the LVEF, LVDd and E/A ratio. Conclusion The EPO level was lower in the high risk patients with ACS compared with those in the lower risk, but the EPO level was elevated much obviously in the high risk patients with ACS after PCI.