SOD水平与急性心肌梗死血运重建患者远期心室重构的相关性

Long-term effects of plasma superoxide dismutase level on left ventricular remodeling in patients with acute ST segment elevation myocardial infarction

目的探讨SOD水平对急性心肌梗死(AMI)血运重建患者远期心室重构的相关性。方法符合纳入标准的心肌梗死血运重建患者67(男60,女7)例,年龄为(58±11)岁,AMI的病程(9.1±2.5)h,收集患者临床基线资料、采集入院24 h内空腹静脉血检测血清超氧化物歧化酶(SOD)、超敏C反应蛋白(hs-CRP)及相关生化指标。随访1年后,按左室舒张末期内径(LVEDD)是否增大分为心脏扩大组(男性LVEDD>55 mm,女性LVEDD>50 mm)和心脏未扩大组。结果心脏扩大组SOD水平显著低于心脏未扩大组(P<0.01);心脏扩大组hs-CRP水平显著高于心脏未扩大组(P<0.01);利用二元Logistic回归模型建立数值间线性关系,得出AMI患者SOD表达水平与LVEDD呈负相关(B=-0.049,P<0.05)。结论 SOD水平与AMI血运重建患者心室重构有相关性。

AIM To explore the effects of superoxide dismutase （SOD） level on long-term ventricular remodeling in patients with acute ST segment elevation myocardial infarction （STEMI）. METHODS Sixty-seven patients [60 males and seven females, mean age （58 ＋11） years] suffering from STEMI for （9. 1 ：!： 2.5 ） h were included in our study. Clinical baseline data and related biochemical indexes consisting of SOD and hs-CRP were collected within 24 h of admission. All patients were followed-up with echocardio- graphy for 1 year and according to the follow-up results they were divided into enlarged left ventricular group （ left ventricular end diastolic diameter, LVEDD I〉 55 mm for males and LVEDD I〉 50 mm for females） and normal left ventricular group （LVED 55 mm for males and LVEDD 50 mm for females）. RESULTS Plasma SOD levels in enlarged left ventricle group were significantly lower than in normal left ventricle group （P 〈 0. 01 ）. Furthermore, SOD in plasma was negatively related to LVEDD in patients with STEMI using logistic regression model （ B = -0. 049, P 〈 0. 05）. Plasma hs-CRP in enlarged left ventricle group was significantly higher than in normal left ventricle group （P 〈 0. 01 ）. CONCLUSION Decrease in plasma SOD is associated with size of left ventricle, indicating that the SOD level is one major reason for poor prognosis in STEMI patients.