血清黏着斑激酶及左心室质量指数与老年急性ST段抬高型心肌梗死患者经皮冠状动脉介入术后左心室重构的关系

Relationship between serum focal adhesion kinase,left ventricular mass index and left ventricular remodeling in elderly patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention

目的探讨血清黏着斑激酶(FAK)水平及左心室质量指数(LVMI)与老年急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)术后左心室重构的关系。方法选取2017年1月至2018年1月华北石油管理局总医院收治的102例老年急性STEMI行PCI治疗患者作为观察组,选取同期于本院行健康体格检查的50例志愿者作为对照组。根据观察组患者是否发生左心室重构,分为重构组(36例)和非重构组(66例)。观察组于入院48 h内和PCI术后6个月、对照组于入组时行血清FAK水平、心脏超声检查,比较观察组与对照组以及重构组与非重构组检查结果的差异。结果观察组入院48 h内血清FAK水平、LVMI均高于对照组[(31±5)μg/L比(25±4)μg/L、(90±13)g/m^(2)比(80±13)g/m^(2)],左心室射血分数(LVEF)低于对照组[(55±10)%比(65±13)%],差异均有统计学意义(均P<0.001)。PCI术后6个月,重构组血清FAK水平、左心室舒张末期容积(LVEDV)、LVMI均高于本组入院48 h内,且均高于非重构组[(47±6)μg/L比(33±5)μg/L、(117±16)ml比(102±14)ml、(96±15)g/m^(2)比(90±14)g/m^(2)],LVEF低于入院48 h内,且低于非重构组[(49±8)%比(55±9)%],差异均有统计学意义(均P<0.05)。Pearson相关性分析显示,重构组血清FAK水平及LVMI与LVEDV均呈正相关、与LVEF均呈负相关(r=0.594、0.543、-0.369、-0.411,均P<0.001)。结论老年急性STEMI PCI术后左心室重构患者血清FAK水平、LVMI与LVEDV呈正相关,与LVEF均呈负相关,FAK、LVMI水平升高可能提示左心室结构改变。

Objective To investigate the relationship between serum focal adhesion kinase(FAK)level,left ventricular mass index(LVMI)and left ventricular remodeling in elderly patients with acute ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods Totally 102 elderly acute STEMI patients who underwent PCI in Huabei Petroleum Administration Bureau General Hospital from January 2017 to January 2018 were enrolled as observation group.Fifty healthy volunteers who underwent physical examination in the hospital at the same period were enrolled as control group.According to occurrence of left ventricular remodeling in patients of observation group,they were divided into remodeling group(36 cases)and non-remodeling group(66 cases).Serum FAK levels and echocardiogram were detected within 48 h of admission and 6 months after PCI in observation group and at enrollment in control group,and were compared between observation group and control group,remodeling group and non-remodeling group.Results The serum FAK level and LVMI of observation group within 48 h after admission were higher than those of control group[(31±5)μg/L vs(25±4)μg/L,(90±13)g/m^(2)vs(80±13)g/m^(2)],and left ventricular ejection fraction(LVEF)of observation group was lower than that of control group[(55±10)%vs(65±13)%](all P<0.001).Six months after PCI,serum FAK level,left ventricular end diastolic volume(LVEDV)and LVMI of remodeling group were higher than those within 48 h after admission and those of non-remodeling group[(47±6)μg/L vs(33±5)μg/L,(117±16)ml vs(102±14)ml,(96±15)g/m^(2)vs(90±14)g/m^(2)];LVEF of remodeling group was lower than that within 48 h after admission and that of non-remodeling group[(49±8)%vs(55±9)%](all P<0.05).Pearson correlation analysis showed that serum FAK level and LVMI in remodeling group were positively correlated with LVEDV,and negatively correlated with LVEF(r=0.594,0.543,-0.369,-0.411,all P<0.001).Conclusions Serum FAK level and LVMI are positively correlated with LVEDV and negatively correlated with LVEF in acute STEMI elderly patients with left ventricular remodeling after PCI.The increase of serum FAK level and LVMI may indicate the structural change of left ventricle.