早期HMGB1水平与AMI患者行急诊PCI院内发生心力衰竭的相关性

Correlation studies between early HMGB1 levels and heart failure in AMI patients undergoing emergency PCI

目的观察和分析早期高迁移率族蛋白B1(high mobility group box 1 protein,HMGB1)水平与急诊冠状动脉介入(PCI)治疗患者术后发生力衰竭的相关性。方法回顾分析行急诊PCI的急性心肌梗死(AMI)患者86例,分为发生院内心力衰竭组(心衰组,n=17)和非心衰组(n=69)。所有患者均于入院即刻及发生心力衰竭时采集肘静脉测定氨基末端脑钠尿肽前体(N-terminal probrain natriuretic peptides,NT-proBNP)浓度,并同时于入院即刻采血测定HMGB1浓度。入院当时及发作心力衰竭24 h内进行心脏多普勒超声心动图检查,分别记录左心室射血分数(LVEF)、舒张早期血流峰速度(E)/舒张晚期血流峰速度(A)以及每搏排出量和每分排出量4项指标。分析血浆HMGB1水平与NT-proBNP水平和超声心动图反映心功能的每搏排出量、每分排出量、LVEF、E/A各指标之间的相关性以及血浆NT-proBNP水平与反映心功能各数值之间的相关性。结果与非心衰组比较,院内心衰组超声心动图4项反映心脏功能的指标均降低,而早期HMGB1水平反而升高,且两组间比较差异均具有统计学意义(均P<0.05)。早期HMGB1水平与发生心力衰竭患者的NT-proBNP水平呈正相关,而与超声心动图反映心脏功能的每搏排出量、每分排出量、LVEF、E/A呈负相关。二元Logistic回归分析提示:早期血浆HMGB1水平与AMI行急诊PCI患者心功能具有显著的正相关性。结论早期HMGB1水平与急诊PCI患者术后发生心力衰竭之间具有明显的相关性。

AIM Observation and analysis of the early high mobility group protein B1 level, to explore the correlation between early HMGB1 levels and heart failure in patients with acute myocardial infarction （AMI） proceeding emergency percutaneous coronary intervention （PCI）. METHODS retrospective analysis in AMI patientswith 86 eases, divided into heart failure group （n = 17） and control group （n = 69）. All patients collected elbow vein in admitted to hospital immediately and heart failure occured respectively to measure concentration of N-terminal probrain natriurefic peptides （NT-proBNP）, and concentration of HMGB1 in admitted to hospital immediately. In admitted to hospital immediately and the onset of heart failure in 24 hours for cardiac doppler echocardiography, record the left ventricular ejection fraction （LVEF）. .cardiac output and output per minute. Analysis of plasma HMGB1 levels and the NT-proBNP level, the relationship between the cardiac function and plasma NT-proBNP level and cardiac output, per minute output reflect cardiac function, LVEF, E/A ratio of the correlation between the numerical. RESULTS compared with control group, echocardiography four indicators in the heart failure group were lower, while early HMGB1 levels rise, the difference had statistical significance （ P 〈 0. 05 ）. HMGB1 levels and occurred in patients with heart failure was positively related to the level of the NT - proBNP and every cardiac output, LVEF, per minute output, E/A ratio negatively correlated. Binary Logistic regression analysis： the plasma levels of HMGB1 and AMI underwent emergency PCI in patients with cardiac function has significant positive correlation. CONCLUSION There were obvious correlation between early HMGB1 levels and heart failure in patients with AMI proceeding PCI.