ST段抬高型心肌梗死患者血清可溶性晚期糖基化终产物受体的表达及意义

Expression of serum soluble receptor for advanced glycation end products in patients with ST -segment elevation myocardial infarction

目的观察ST段抬高型心肌梗死（STEMI）患者血清可溶性晚期糖基化终产物受体（sRAGE）水平的动态波动。方法选择74例STEMI患者，其中伴2型糖尿病（T2DM）者与不伴糖尿病者各37例；均测定入院第1、2、7日血清sRAGE及心肌肌钙蛋白（cTNI）水平。并选取T2DM无并发症者和健康体检者各30例，测定入院第2日或体检当日空腹血清sRAGE及cTNI水平。结果STEMI患者第1、2日血清sRAGE水平较单纯T2DM患者及健康体检者明显升高（P〈0．01）；STEMI伴T2DM患者第1、2、7日血清sRAGE表达水平较STEMI不伴糖尿病患者升高（P〈0．01）。STEMI患者第1、2日sRAGE水平无显著差异（P=0．191），但均高于第7日sRAGE水平（P〈0．01）。STEMI患者血清sRAGE1水平与cTNIm水平呈正相关（r=0．749）。结论STEMI患者血清sRAGE升高；sRAGE对STEMI心肌坏死程度可能有预测价值。

Objective To investigate the dynamic changes of serum soluble receptor for advanced glycation, end products （sRAGE） in patients with ST- segment elevation myocardial infarction （STEMI）. Methods A total of 74 STEMI patients were enrolled in the current study, including 37 participants with T2DM and 37 without diabetes. They were subjected to measurement for the levels of serum sRAGE and cardiac troponin I （cTNI） on Days 1, 2 and 7 after admitted into our hospital. Meanwhile, 30 T2DM patients without complications and 30 healthy subjects were selected to examine their amounts of fasting serum sRAGE and cTNI on Day 2 after admitted on the day of body examination. Results The serum level of sRAGE was remarkably elevated in patients suffering from STIEMI alone than those in the T2DM and control groups on Days 1 and 2 （ P 〈 0.01 ）. STIEMI patients with T2DM produced higher serum quantities of sRAGE than those without DM on Days 1 and 2 （P 〈0.01 ）. The amounts of sRAGE in the STEMI group on Days 1 and 2, despite no statistical difference was found between them, were higher that on Day 7 （P 〈 0.01 ）. The STEMI group presented the level of serum sRAGE that was positively related with the level of cTNI （r = 0. 749）. Conclusion An elevated level of serum sRAGE is determined in patients with STEMI, which indicates the potential role of sRAGE to predict the extent of STEMI.