急性冠脉综合征患者介入治疗前后Apelin水平变化

The Changes of Plasma Apelin Level in Patients with Acute Coronary Syndrome before and after Intervention Treatment

目的观察急性冠脉综合征(ACS)患者血浆Apelin水平的变化并探讨其临床意义。方法随机选取64例于2015年1—10月在该院心内科确诊为ACS并成功完成经皮冠状动脉成形术(PCI)的患者,分别在术前、术后24 h收集静脉血浆,酶联免疫吸附法测定血浆Apelin水平;进一步对不稳定性心绞痛(UA)及急性心肌梗死(AMI)患者(两组分别为34、30例)进行亚组分析。同期30名健康志愿者为对照组(NC组)。结果与NC组比较,ACS组血浆Apelin水平在术前明显下降[(36.2±8.1)pg/m L vs(56.4±9.4)pg/m L,(36.2±8.1)pg/m L vs(45.3±7.3)pg/m L,P<0.05];且AMI组血浆Apelin水平又低于UA组水平[(36.2±8.1)pg/m L vs(45.3±7.3)pg/m L,P<0.05]。与术前比较,术后24 h ACS患者Apelin水平明显升高[AMI组:(45.3±9.3)pg/m L vs(36.2±8.1)pg/m L,UA组:(51.8±8.7)pg/m L vs(45.1±7.3)pg/m L,P<0.05]。结论ACS患者PCI术后存在血浆Apelin表达的升高,提示PCI可促进急性冠脉综合征患者Apelin分泌,Apelin可能参与冠心病的病理生理过程,并具有心脏保护作用。

Objective This paper tries to observe the changes of plasma Apelin level in patients with acute coronary syndrome(ACS)and to explore its clinical significance.Methods 64 patients who were diagnosed as ACS and successfully completed percutaneous transluminal coronary angioplasty(PCI)in the hospital from January to October 2015 were enrolled.Venous plasma was collected preoperatively and 24 hours after surgery.Enzyme-linked immunosorbent assay Apelin levels were determined by the adsorption method.Subtypes were further analyzed in patients with unstable angina(UA)and acute myocardial infarction(AMI)(34,30 in each group).30 healthy volunteers in the same period as the control group(NC group).Results Compared with NC group,plasma Apelin level in ACS group decreased significantly[(36.2±8.1)pg/mL vs(56.4±9.4)pg/mL,(36.2±8.1)pg/mL vs(45.3±7.3)pg/mL,(P<0.05)],and the level of Apelin in AMI group was lower than that in UA group[(36.2±8.1)pg/mL vs(45.1±7.3)pg/mL,P<0.05].Compared with the preoperative level,Apelin levels significantly increased in patients with ACS at 24 hours after operation[AMI group:(45.3±9.3)pg/mL vs(36.2±8.1)pg/mL;UA group:(51.8±8.7)pg/mL vs(45.3±7.3)pg/mL,P<0.05].Conclusion The increase of plasma Apelin expression in ACS patients after PCI suggests that PCI can promote Apelin secretion in patients with acute coronary syndromes.Apelin may be involved in the pathophysiology of coronary heart disease and has cardioprotective effects.