Rho激酶对急性冠脉综合征患者左心功能的影响

Influence of Rho-kinase on Left Heart Function in Patients with Acute Coronary Syndrome

目的探讨Rho激酶活性对急性冠脉综合征(ACS)患者左心功能的影响。方法入选2013年3月至2014年12月间我科收治的ACS患者180例,根据Rho激酶活性的高低分为高活性组和低活性组,随访12个月,对比观察2组入院时、治疗结束出院后3和12个月Rho激酶活性、氨基末端脑钠肽前体(NT-pro BNP)水平和左心功能指标的差异,评价Rho激酶对ACS患者左心功能的影响以及对治疗结束后12个月ACS患者左心功能的预测价值。结果随访12个月时,高活性组Rho激酶和NT-proBNP水平明显高于低活性组(P<0.05)。高活性组左房内径、左室舒张末期内径值明显高于低活性组(P<0.05),左室射血分数和心脏指数明显低于低活性组(P<0.05)。相关性分析显示,Rho激酶与NT-pro BNP呈正相关(r=0.685,P<0.01)。logistic回归分析显示,Rho激酶活性是影响ACS患者治疗结束后12个月左心功能的独立预测因子(P<0.05)。结论 Rho激酶与NT-proBNP呈正相关,可作为评价ACS患者左心功能的一项可靠指标。Rho激酶是ACS患者治疗结束后12个月左心功能的独立预测因子。

Objective To explore the influence of Rho-kinase activity on left heart function in patients with acute coronary syndrome （ACS）. Methods A total of 180 patients with ACS, according to the level of Rho-kinase activity, were enrolled for the study and divided into highly reac- tive group and lowly reactive group. The changes of Rho-kinase activity, N-terminal pro-B-type natriuretic peptide （NT-proBNP） and left heart function were detected in each group. The influence of Rho-kinase activity on left heart function within 12 months was analyzed. Results The Rho- kinase activity and NT-proBNP were significantly higher in highly reactive group compared with lowly reactive group （P 〈 0.05）. At 12-month fol- low-up, the measurements of left ventricular end diastolic diameter and left atrial diameter in highly activity group were significantly larger than those in lowly activity group （P 〈 0.05）. The left ventricular ejection fraction and cardiac index were significantly smaller than those in lowly activi- ty group （P 〈 0.05）. There was positive correlation between Rho-kinase activity and NT-proBNP. The logistic regression analysis displayed that Rho-kinase activity is an independent risk factor which may predict the left heart function of ACS patients within 12 months after admission. Con- clusion Rho-kinase could be a rehable parameter for evaluating the severity of left heart function in ACS patients, which is also an independent predictive biomarker of left heart function in ACS patients within 12 months after admission.