急性心肌梗死并发恶性室性心律失常患者血清半乳糖凝集素-3、生长分化因子15水平及其临床意义

Serum galectin-3 and growth differentiation factor 15 levels and their clinical significance in acute myocardial infarction patients complicated with malignant ventricular arrhythmia

目的探讨急性心肌梗死(AMI)并发恶性室性心律失常(MVA)患者血清半乳糖凝集素-3(Gal-3)、生长分化因子15(GDF-15)水平及其临床意义。方法回顾性分析90例AMI患者的临床资料,其中合并MVA 34例(并发MVA组),无MVA 56例(无MVA组)。比较两组患者心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、Gal-3、GDF-15水平,分析AMI患者并发MVA的危险因素。结果并发MVA组患者的年龄、Killip分级、病变血管支数均高于或多于无MVA组,心肌梗死溶栓(TIMI)血流分级低于无MVA组(均P<0.05);并发MVA组患者的cTnI、CK-MB、Gal-3及GDF-15水平高于无MVA组(均P<0.05)。相关分析结果显示,AMI患者的Gal-3及GDF-15水平与cTnI、CK-MB水平均呈正相关(均P<0.05);多因素Logistic回归分析结果显示,Killip分级、病变血管支数、TIMI血流分级、cTnI、CK-MB、Gal-3、GDF-15水平为AMI患者并发MVA的影响因素(均P<0.05)。结论AMI并发MVA患者的Gal-3和GDF-15水平升高,高Gal-3和GDF-15水平为AMI患者并发MVA的危险因素。

Objective To explore serum galectin-3(Gal-3)and growth differentiation factor 15(GDF-15)levels and their clinical significance in acute myocardial infarction(AMI)patients complicated with malignant ventricular arrhythmia(MVA).Methods The clinical data of 90 AMI patients were analyzed retrospectively,including 34 cases complicated with MVA(complication of MVA group)and 56 cases without MVA(non-MVA group).The levels of cardiac troponin I(cTnI),creatinine kinase MB isoenzyme(CK-MB),Gal-3 and GDF-15 were compared between the two groups,and the risk factors for developing complication of MVA in patients with AMI were analyzed.Results Compared to the non-MVA group,the complication of MVA group had older age,higher Killip grade,more disease vessels,and lower thrombolysis in myocardial infarction(TIMI)flow grade(all P<0.05);the complication of MVA group exhibited higher levels of cTnI,CK-MB,Gal-3 and GDF-15 than the non-MVA group(all P<0.05).The correlation analysis results showed that Gal-3 and GDF-15 levels positively correlated with cTnI and CK-MB levels in AMI patients(all P<0.05);multivariate Logistic regression analysis results showed that Killip grade,number of vessel branches in lesions,TIMI flow grade,cTnI,CK-MB,Gal-3 and GDF-15 levels were the influencing factors of developing complication of MVA in AMI patients(all P<0.05).Conclusion AMI patients complicated with MVA experience elevated levels of Gal-3 and GDF-15,and high Gal-3 and GDF-15 levels are the risk factors for developing complication of MVA in AMI patients.