FKN在急性心肌梗死早期诊断中的作用

The Role of FKN in Early Diagnosis of Acute Myocardial Infarction

目的通过研究不规则趋化因子(FKN)在急性ST段抬高型心肌梗死(STEMI)、急性非ST段抬高型心肌梗死(NSTEMI)和不稳定型心绞痛(UA)患者血清中的表达,明确FKN在急性心肌梗死(AMI)早期诊断中的作用。方法选择STEMI患者65例(A组)、NSTEMI患者24例(B组)、UA患者28例(C组),同时选择以胸痛为表现但行冠脉造影检查排除冠心病的患者32例(对照组,D组),比较4组受试者在不同时间点[冠脉造影检查和(或)介入治疗术前、术后4 h、术后24 h]血清心肌坏死标记物FKN水平的差异。结果 A组与B组之间、AMI患者与非AMI患者之间在术前、术后4 h以及术后24 h在磷酸肌酸激酶(CK)、磷酸肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(c Tn T)水平及冠脉Gensini评分方面存在统计学差异(P<0.05)。术前、术后4 h,A组、B组、C组和D组的FKN浓度值依次降低,各组之间有统计学差异(P<0.05)。术后24 h,A组与B组FKN浓度值明显高于C组与D组(P<0.05)。术后1周,A组与B组、D组相比FKN浓度值均有统计学差异(P<0.05)。术后4 h FKN表达和CK、CK-MB、c Tn T以及与冠脉Gensini评分均呈正相关(P<0.05),其中,与c Tn T的相关性最佳(r=0.760)。结论 FKN在AMI早期即可明显升高,与梗死的心肌面积明显相关,可以作为AMI早期诊断和判断预后的指标。

ObjectiveTo clarify the role of FKN in early diagnosis of acute myocardial infarction（AMI）by studying the expression of FKN in pa-tients with acute ST segment elevation myocardial infarction（STEMI）,acute non ST segment elevation myocardial infarction（NSTEMI）or unsta-ble angina（UA）.MethodsSixty-five patients with STEMI（group A）,twenty-four patients with NSTEMI（group B）,twenty-eight patients withUA（group C）and thirty-two patients with chest pain as the manifestation whose coronary angiography excluded heart disease（control group,groupD）were enrolled. The levels of the serum myocardial necrosis markers and FKN were compared in the four groups at different time points（at coro-nary angiographic test and/or before interventional operation,4 h after operation,24 h after operation）.ResultsThere were significant differencesin creatine kinase（CK）,creatine kinase-MB（CK-MB）,cardiac troponin T（c Tn T）and coronary Gensini score in patients in group A vs. group B,AMI patients in groups A and B vs. non-AMI patients in groups C and D before operation,at 4 h and 24 h after operation（P〈0.05）. The expressionlevel of FKN before operation and at 4 h after operation reduced in group A,group B,group C and group D in order,and the difference was signifi-cant（P〈0.05）. The expression level of FKN at 24 h after operation in group A and group B was significantly higher than that in group C and groupD（P〈0.05）. The expression level of FKN at one week after operation in group A was significant lower compared with group B and group D（P〈0.05）. There was a positive correlation with the expression level of FKN at 4 h after operation with coronary Gensini score,CK,CK-MB,and c Tn T（P〈0.05）. The best correlation of the expression level of FKN at 4 h after operation was with c Tn T（r = 0.760）.ConclusionThe level of FKN inearly AMI patients can be significantly increased and associated with the area of myocardial infarction,which can be used as biomarker of AMI forearly diagnosis and prognosis.