AMI患者血清甲壳质酶蛋白-40水平与心室重构的相关性分析

Correlation between serum YKL-40 levels and ventricular remodeling in patients with AMI

目的探讨急性心肌梗死(AMI)患者血清甲壳质酶蛋白-40(YKL-40)水平与心室重构的相关性。方法以2015年1月至2017年1月青岛大学附属医院收治的80例AMI患者(AMI组)和同期收治的35例稳定型冠心病患者(对照组)为研究对象,AMI组分别于胸痛症状发生后0～12h、>12～24h、>24～48h、>48～72h、>72～96h、>96h测定血清YKL-40水平,对照组入组24h测定血清YKL-40水平,两组均行心脏彩超检查测定左室容积、左室射血分数(LVEF),并分析AMI患者血清YKL-40水平与心室重构的相关性。结果 AMI组不同时间血清YKL-40水平在0～12h达最高峰,24h后呈下降趋势,且>24～48h、>48～72h、>72～96h、>96h维持在一个平台期,AMI组所有时间点内YKL-40水平均明显高于对照组(P<0.01);AMI组血清YKL-40最高峰、最低峰时左室容积、LVEF均明显低于对照组(P<0.01);AMI组血清YKL-40高峰期水平与LVEF呈负相关关系(r=-0.321,P<0.01),与左室容积呈正相关关系(r=0.351,P<0.01);血清YKL-40平台期水平与LVEF呈正相关关系(r=0.258,P<1),但与左室容积呈负相关关系(r=-0.387,P<0.01)。结论 AMI患者血清YKL-40水平明显升高,YKL-40高峰期水平与AMI心室重构呈正相关关系,YKL-40平台期水平与AMI心室重构呈负相关关系。

Objective To investigate the correlation between serum YKL-40 levels and ventricular remodeling in patients with acute myocardial infarction(AMI).Methods A total of 80 patients with AMI(AMI group)and 35 patients with stable coronary heart disease(control group)treated in our hospital from January 2015 to January 2017 were selected as the subjects.Serum YKL-40 levels in AMI group were determined at 0-12 h,>12-24 h,>24-48 h,>48-72 h,>72-96 h and>96 h after the onset of chest pain,and the levels in control group were determined at 24 h after admission.The left ventricular volume and left ventricular ejection fraction(LVEF)were measured by doppler echocardiography,and the correlation between serum YKL-40 levels and ventricular remodeling in patients with AMI was analyzed.Results Serum YKL-40 levels in AMI group reached the peak in 0-12 h,and showed a downward trend after 24 h.In>24-48 h,>48-72 h,>72-96 h and>96 h,the levels maintained at a level.Serum YKL-40 levels in AMI group at different time points were significantly higher than those in the control group(P<0.01).The left ventricular volume and LVEF in AMI group at peak and the lowest peak values of YKL-40 were significantly lower than those in the control group(P<0.01).The peak serum YKL-40 levels in patients with AMI were negatively correlated with LVEF(r=-0.321,P<0.01),and positively correlated with left ventricular volume(r=0.351,P<0.01).The platform level of YKL-40 was positively correlated with LVEF(r=0.258,P<0.01),and negatively correlated with left ventricular volume(r=-0.387,P<0.01).Conclusion Serum YKL-40 levels are significantly higher in patients with AMI.The peak level of YKL-40 is positively correlated with ventricular remodeling while the platform level of YKL-40 is negatively correlated with ventricular remodeling in patients with AMI.