FGF-23与STEMI患者行急诊PCI后左室重构的相关性研究

Correlative study between fibroblast growth factor-23 and left ventricular remodeling in STEMI patients undergoing emergency PCI

目的研究成纤维细胞生长因子-23(Fibroblast growth factor-23,FGF-23)在急性广泛前壁ST段抬高型心肌梗死(STEMI)患者行急诊经皮冠状动脉介入术(PCI)后血清中的表达情况,探讨FGF-23与STEMI后左室重构(LVR)的相关性,为临床早期识别、检测出存在LVR风险的STEMI患者提供新的方法。方法连续选取急性广泛前壁STEMI患者86例,以左室重构率(rLVR)≥20%分为LVR组25例,非LVR组61例。采用ELISA夹心法检测血清FGF-23水平。结果血清FGF-23水平,LVR组(209.60±26.10)U/mL,高于非LVR组的(161.89±12.09)U/mL,差异有统计学意义(P<0.05);LVR组rLVR与FGF-23水平相关性良好(r=0.611,P<0.05)。LVR组预后不良率较非LVR组高(P<0.05)。结论LVR组FGF-23水平、预后不良率均高于非LVR组,表明STEMI患者的病情越严重,血清FGF-23水平越高。FGF-23可作为STEMI后LVR新的预测因子。

Objective To study the levels of the serum fibroblast growth factor-23(FGF-23)in acute anterior ST-segment elevation myocardial infarction(STEMI)patients undergoing emergency percutaneous coronary intervention(PCI)and to explore the correlation between the levels of the serum FGF-23 and left ventricular remodeling(LVR)after STEMI,and to provide new ideas or new methods for early detection the patients with LVR after STEMI undergoing PCI.Methods 86 patients with acute extensive anterior wall STEMI were divided into LVR group(n=25)and non-LVR group(n=61)according to the rates of the left ventricular remodeling(rLVR%)and rLVR%≥20%.The levels of the serum FGF-23 was measured by ELISA sandwich method.Results The levels of the serum FGF-23 in LVR group was higher than that in non-LVR group(P<0.05),and the rLVR%of the LVR group well correlated with the levels of the serum FGF-23(r=0.509,P<0.05).Conclusion The serum FGF-23 level indicates poor prognosis in LVR group higher than those in non-LVR group.It’s indicated that the more serious the condition of the STEMI patients,the higher levels of the serum FGF-23.FGF-23 could be used as a new predictor of the LVR after the STEMI.