急性心肌梗死患者行急诊冠脉支架植入术后血浆循环微粒水平的变化及意义

Changes of plasma circulating microparticles in acute myocardial infarction patients after the emergency coronary stent implantation

目的探讨急性心肌梗死(AMI)患者行急诊经皮冠脉支架植入(PCI)术前后体内循环微粒(MPs)水平的变化及意义。方法以就诊于新疆医科大学第一附属医院的AMI 38例患者为研究对象,抽取入院时及急诊PCI术后30 min时的血液,通过两步离心法提取MPs,分析比较手术前后血浆MPs的浓度变化情况及术后MPs浓度与术后心血管事件的相关性及对内皮细胞一氧化氮合酶(e NOS)表达的影响。结果与术前比较,PCI术后患者血浆中MPs浓度明显升高[(2.46±0.53)mg/ml vs(4.31±0.67)mg/ml,P<0.05]。而且术后MPs浓度与术后心血管事件次数呈正相关(rs=0.59,P<0.000 1)。与术前比较,术后MPs明显抑制了内皮细胞e NOS蛋白的表达(P<0.01)。结论急诊PCI术后血浆MPs浓度有作为间接反映预后检测指标的潜能。

Objective To investigate the clinical value of circulating microparticles（ MPs） levels in patients with acute myocardial infarction（ AMI） undergoing emergency percutaneous coronary stent implantation（ PCI）. Methods Thirty-eight patients with AMI in the department of cardiac surgery in First Affiliated Hospital of Xinjiang Medical University were recruited,and blood was extracted on admission day and 30 min after emergency PCI. Then,MPs were obtained by two steps centrifugation and detected before and after surgery. The correlation of MPs with postoperative cardiovascular events and the effects on e NOS in endothelial cells were analyzed. Results MPs levels were significantly increased after PCI[（ 2. 46 ± 0. 53） mg / ml vs（ 4. 31 ± 0. 67） mg / ml,P〈0. 05]. MPs content was positively correlated with incidences of postoperative cardiovascular events（ rs= 0. 59,P〈0. 000 1）. After surgery,the expression of e NOS was inhibited by MPs in patients suffering PCI（ P〈0. 01）. Conclusion The MPs content in plasma after emergency PCI have the potential to be used as an indirect indicator of prognosis.