摘要
目的：探讨急性心肌梗死患者早期血清可溶性ST2（sST2）水平及其与心肌活性的关系。方法采用ELISA法检测30例发病12 h以内的非ST段抬高型心肌梗死（NSTEMI）患者血清sST2水平，于发病后第7天行心脏磁共振检查并根据磁共振结果将患者分为透壁增强组、非透壁增强组和混合组。于7-14 d行PCI术，并于术后6个月再次行心脏磁共振检查评估心肌活性，观察指标包括梗死心肌质量、左心室射血分数及室壁运动异常评分在术前及术后的变化及其与心肌梗死早期血清sST2水平的关系。结果透壁增强组血清sST2的水平较之非透壁增强组及混合组明显升高（P＜0.05），混合组较非透壁增强组高（P＜0.05）；梗死心肌质量及室壁运动异常评分在3组患者PCI术后均减少，梗死心肌质量在非透壁增强组及混合组中减少有统计学差异（P＜0.05），室壁运动异常评分在非透壁增强组降低显著（P＜0.05）；左心室射血分数在3组患者PCI术后均增加，在非透壁增强组及混合组中增加有统计学差异（P＜0.05）。心肌梗死早期血清sST2水平与PCI术前及PCI术后6个月的心肌活性相关。结论急性心肌梗死早期血清中sST2的水平可反映心肌受损情况并可预测心肌梗死7 d PCI术前及PCI术后6个月的心肌活性。
ObjectiveTo investigate the levels of serum soluble ST2 in patients with early myocardial infarction and its relationship with myocardial viability.MethodsThe levels of serum soluble ST2 was measured with ELISA assay within 12 hours of the onset of NSTEMI in 30 patients, and 30 patients were subjected to cardiac magnetic resonance imaging on the 7th day of myocardial infarction and were divided into the following three groups by the transmural extent of myocardial infarction manifested in the delayed enhancement magnetic resonance imaging（DE-MRI）：transmural enhancement group, non-transmural enhancement group and mixed group. All patients underwent PCI at 7-14 days after AMI and cardiac magnetic resonance imaging 6 months after the procedure to analyse the infarct mass, abnormal wall motion score and left ventricular ejection fraction（LVEF） and their relationship with the levels of serum ST2 in early stage of myocardial infarction.ResultsThe levels of serum ST2 in transmural enhancement group was significantly higher than that of non-transmural group and mixed group （P〈0.05）, mixed groupvs. non-transmural （P〈0.05）; Compared with the parameters before PCI, the infarct mass and abnormal wall motion score in three groups after PCI were decreased, but the infarct mass after PCI was significantly decreased in the non-transmural enhancement group and mixed group（P〈0.05）. Abnormal wall motion score was significantly decreased in the non-transmural enhancement group after PCI（P〈0.05）. LVEF was significantly improved after PCI in three groups, but the improvement in non-transmural enhancement group and mixed group were more significant（P〈0.05）. The levels of serum soluble ST2 in patients with early myocardial infarction were related with myocardial viability before PCI and 6 months after the procedure.ConclusionThe levels of serum soluble ST2 might imply myocardial injury in early myocardial infarction, and could be used to predict myocardial viability on the 7th day of myocardial infarction before PCI and 6 months after the procedure.
出处
《中华临床医师杂志（电子版）》
CAS
2014年第13期13-16,共4页
Chinese Journal of Clinicians(Electronic Edition)
基金
山西省卫生厅科技攻关项目(20100205)
